Provider Demographics
NPI:1568814150
Name:CHRISTOPHER CHEN, DDS, MSD, INC.
Entity Type:Organization
Organization Name:CHRISTOPHER CHEN, DDS, MSD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:310-721-2716
Mailing Address - Street 1:19217 COLIMA RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-3015
Mailing Address - Country:US
Mailing Address - Phone:626-581-9100
Mailing Address - Fax:
Practice Address - Street 1:19217 COLIMA RD
Practice Address - Street 2:SUITE B
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-3015
Practice Address - Country:US
Practice Address - Phone:626-581-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA620541223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty