Provider Demographics
NPI:1538142948
Name:CHINN, COURTNEY (DDS)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:CHINN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 CANAL ST
Mailing Address - Street 2:#2A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-6013
Mailing Address - Country:US
Mailing Address - Phone:646-232-3093
Mailing Address - Fax:
Practice Address - Street 1:125 WALKER ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4108
Practice Address - Country:US
Practice Address - Phone:212-226-9339
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050386122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist