Provider Demographics
NPI:1295867257
Name:CHIOU, JOHN LEE (DMD, MMSC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LEE
Last Name:CHIOU
Suffix:
Gender:M
Credentials:DMD, MMSC
Other - Prefix:DR
Other - First Name:JOHNNY
Other - Middle Name:LEE
Other - Last Name:CHIOU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD, MMSC
Mailing Address - Street 1:475 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NH
Mailing Address - Zip Code:03870-2459
Mailing Address - Country:US
Mailing Address - Phone:603-436-5646
Mailing Address - Fax:
Practice Address - Street 1:475 WASHINGTON RD.
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NH
Practice Address - Zip Code:03870-5431
Practice Address - Country:US
Practice Address - Phone:603-436-5646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH35791223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics