Provider Demographics
NPI:1518068816
Name:MAI, CHAULINH C (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHAULINH
Middle Name:C
Last Name:MAI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15266 GOLDENWEST ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-6169
Mailing Address - Country:US
Mailing Address - Phone:714-379-3100
Mailing Address - Fax:714-893-8868
Practice Address - Street 1:15266 GOLDENWEST ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-6169
Practice Address - Country:US
Practice Address - Phone:714-379-3100
Practice Address - Fax:714-893-8868
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA382041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB38204OtherHEALTHY FAMILY
CAG92233OtherDENTICAL