Provider Demographics
NPI:1407417959
Name:CHEN, ALEXANDRA ANYEN (DDS, MS)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:ANYEN
Last Name:CHEN
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 SETON PKWY STE 425
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-6180
Mailing Address - Country:US
Mailing Address - Phone:512-504-3637
Mailing Address - Fax:
Practice Address - Street 1:1180 SETON PKWY STE 425
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6180
Practice Address - Country:US
Practice Address - Phone:512-504-3637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX383121223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty