Provider Demographics
NPI:1326299900
Name:BASKIN, ANGELA CHUN (DDS)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:CHUN
Last Name:BASKIN
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 1:42201 N. 41ST DR
Mailing Address - Street 2:STE #156
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086
Mailing Address - Country:US
Mailing Address - Phone:623-551-3511
Mailing Address - Fax:623-551-3513
Practice Address - Street 1:42201 N. 41ST DR
Practice Address - Street 2:STE #156
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086
Practice Address - Country:US
Practice Address - Phone:623-551-3511
Practice Address - Fax:623-551-3513
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD46611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice