Provider Demographics
NPI:1689659518
Name:CHIE, LINDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:CHIE
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:VA NORTHERN CALIFORNIA HEALTH CARE SYSTEM
Mailing Address - Street 2:BLDG. 201, WALNUT AVE. DENTAL CLINIC
Mailing Address - City:MARE ISLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94592
Mailing Address - Country:US
Mailing Address - Phone:707-562-8225
Mailing Address - Fax:
Practice Address - Street 1:VA NORTHERN CALIFORNIA HEALTH CARE SYSTEN DENTAL CLINIC
Practice Address - Street 2:BLDG. 201, WALNUT AVE.
Practice Address - City:MARE ISLAND
Practice Address - State:CA
Practice Address - Zip Code:94592
Practice Address - Country:US
Practice Address - Phone:707-562-8243
Practice Address - Fax:707-562-8247
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38403122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist