Provider Demographics
NPI:1508319047
Name:DUBLIN FAMILY DENTISTRY
Entity Type:Organization
Organization Name:DUBLIN FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-829-9884
Mailing Address - Street 1:4288 DUBLIN BLVD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-3176
Mailing Address - Country:US
Mailing Address - Phone:925-829-9884
Mailing Address - Fax:925-829-0184
Practice Address - Street 1:4288 DUBLIN BLVD
Practice Address - Street 2:SUITE 209
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-3176
Practice Address - Country:US
Practice Address - Phone:925-829-9884
Practice Address - Fax:925-829-0184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54641122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty