Provider Demographics
NPI:1437324399
Name:STEVEN CHU DDS
Entity Type:Organization
Organization Name:STEVEN CHU DDS
Other - Org Name:CRESCENT DENTAL HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-827-7812
Mailing Address - Street 1:3371 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-2033
Mailing Address - Country:US
Mailing Address - Phone:718-827-7812
Mailing Address - Fax:
Practice Address - Street 1:3371 FULTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-2033
Practice Address - Country:US
Practice Address - Phone:718-827-7812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY367971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01425676Medicaid