Provider Demographics
NPI:1376773036
Name:CHIN, NONELLE D (DDS)
Entity Type:Individual
Prefix:DR
First Name:NONELLE
Middle Name:D
Last Name:CHIN
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 1:910 S KNOTT AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3604
Mailing Address - Country:US
Mailing Address - Phone:714-527-4404
Mailing Address - Fax:714-527-4663
Practice Address - Street 1:910 S KNOTT AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3604
Practice Address - Country:US
Practice Address - Phone:714-527-4404
Practice Address - Fax:714-527-4663
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA553271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice