Provider Demographics
NPI:1659623064
Name:LU, KEVIN CHEW (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:CHEW
Last Name:LU
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 1:19231 COLIMA RD
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-3005
Mailing Address - Country:US
Mailing Address - Phone:562-650-7000
Mailing Address - Fax:626-964-6836
Practice Address - Street 1:19231 COLIMA RD
Practice Address - Street 2:
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-3005
Practice Address - Country:US
Practice Address - Phone:562-650-7000
Practice Address - Fax:626-964-6836
Is Sole Proprietor?:No
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA619681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice