Provider Demographics
NPI:1578698692
Name:CHIN, STEVEN I (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:I
Last Name:CHIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:275 HILLCREST DR SUITE 152
Mailing Address - Street 2:STEVEN I CHIN DDS
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360
Mailing Address - Country:US
Mailing Address - Phone:805-497-9402
Mailing Address - Fax:805-497-3530
Practice Address - Street 1:275 HILLCREST DR SUITE 152
Practice Address - Street 2:STEVEN I CHIN DDS
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360
Practice Address - Country:US
Practice Address - Phone:805-497-9402
Practice Address - Fax:805-497-3530
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA39246122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist