Provider Demographics
NPI:1528569464
Name:HERBERT C K CHIU DDS, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:HERBERT C K CHIU DDS, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-471-3777
Mailing Address - Street 1:2701 DECOTO RD SUITE 4
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587
Mailing Address - Country:US
Mailing Address - Phone:510-471-3777
Mailing Address - Fax:510-471-2085
Practice Address - Street 1:2701 DECOTO RD SUITE 4
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587
Practice Address - Country:US
Practice Address - Phone:510-471-3777
Practice Address - Fax:510-471-2085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA337371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty