Provider Demographics
NPI:1376685271
Name:CHEN, SUSAN SUEHUI (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:SUEHUI
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 1:39200 LIBERTY ST STE A
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1515
Mailing Address - Country:US
Mailing Address - Phone:510-791-1970
Mailing Address - Fax:510-791-0489
Practice Address - Street 1:39200 LIBERTY ST STE A
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1515
Practice Address - Country:US
Practice Address - Phone:510-791-1970
Practice Address - Fax:510-791-0489
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34596122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist