Provider Demographics
NPI:1417003849
Name:DAVID A CHIN DDS APC
Entity Type:Organization
Organization Name:DAVID A CHIN DDS APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:CHIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-790-6721
Mailing Address - Street 1:1808 VERDUGO BLVD
Mailing Address - Street 2:SUITE 312
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-1456
Mailing Address - Country:US
Mailing Address - Phone:818-790-6721
Mailing Address - Fax:818-790-6810
Practice Address - Street 1:1808 VERDUGO BLVD
Practice Address - Street 2:SUITE 312
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-1456
Practice Address - Country:US
Practice Address - Phone:818-790-6721
Practice Address - Fax:818-790-6810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA304261223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB3042601OtherSTATE OF CA