Provider Demographics
NPI:1639703374
Name:CHEN, MENGXIA (DDS, MPH)
Entity Type:Individual
Prefix:
First Name:MENGXIA
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 WYNDALE ST APT 515
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4172
Mailing Address - Country:US
Mailing Address - Phone:443-743-5412
Mailing Address - Fax:
Practice Address - Street 1:412 LAKE RD
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-1402
Practice Address - Country:US
Practice Address - Phone:254-933-7760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX359151223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry