Provider Demographics
NPI:1326354804
Name:CHIU, NICOLE PUI-MING (DMD, MS)
Entity Type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:PUI-MING
Last Name:CHIU
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:946 STOCKTON ST APT 10F
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-1643
Mailing Address - Country:US
Mailing Address - Phone:203-918-6808
Mailing Address - Fax:
Practice Address - Street 1:946 STOCKTON ST APT 10F
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-1643
Practice Address - Country:US
Practice Address - Phone:203-918-6808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA594951223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics