Provider Demographics
NPI:1346240538
Name:CHUI, SAM - (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAM
Middle Name:-
Last Name:CHUI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15934 HALLIBURTON RD
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-3505
Mailing Address - Country:US
Mailing Address - Phone:626-961-6289
Mailing Address - Fax:
Practice Address - Street 1:15934 HALLIBURTON RD
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-3505
Practice Address - Country:US
Practice Address - Phone:626-961-6289
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:2006-03-25
Deactivation Code:
Reactivation Date:2006-04-04
Provider Licenses
StateLicense IDTaxonomies
CA279711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice