Provider Demographics
NPI:1518008788
Name:CHOW, W. DEAN (DDS, PA)
Entity Type:Individual
Prefix:DR
First Name:W.
Middle Name:DEAN
Last Name:CHOW
Suffix:
Gender:M
Credentials:DDS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 5TH ST N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-2203
Mailing Address - Country:US
Mailing Address - Phone:662-328-5411
Mailing Address - Fax:662-328-1775
Practice Address - Street 1:1821 5TH ST N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-2203
Practice Address - Country:US
Practice Address - Phone:662-328-5411
Practice Address - Fax:662-328-1775
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS17081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL11034Medicare UPIN
VA249023Medicare UPIN
000800596Medicare UPIN