Provider Demographics
NPI:1467182212
Name:XU, CHULAN (DH)
Entity Type:Individual
Prefix:MRS
First Name:CHULAN
Middle Name:
Last Name:XU
Suffix:
Gender:F
Credentials:DH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6433 231ST ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2715
Mailing Address - Country:US
Mailing Address - Phone:718-362-7740
Mailing Address - Fax:
Practice Address - Street 1:13250 41ST AVE STE 4
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-1302
Practice Address - Country:US
Practice Address - Phone:718-362-7740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist