Provider Demographics
NPI:1326218173
Name:CHEN, SAMANTHA Y (DDS)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:Y
Last Name:CHEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 W DUARTE RD
Mailing Address - Street 2:A
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-4399
Mailing Address - Country:US
Mailing Address - Phone:626-710-6798
Mailing Address - Fax:626-446-9048
Practice Address - Street 1:3131 SANTA ANITA AVE
Practice Address - Street 2:201
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-1369
Practice Address - Country:US
Practice Address - Phone:626-444-2605
Practice Address - Fax:626-444-0615
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53772122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist