Provider Demographics
NPI:1629406574
Name:CHEW, LAURA KRISTEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:KRISTEN
Last Name:CHEW
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 1:151 S EL MOLINO AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2562
Mailing Address - Country:US
Mailing Address - Phone:626-795-8456
Mailing Address - Fax:
Practice Address - Street 1:151 S EL MOLINO AVE STE 201
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2562
Practice Address - Country:US
Practice Address - Phone:626-795-8456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-30
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA627151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice