Provider Demographics
NPI:1689704231
Name:CHEN, STEPHEN S (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:S
Last Name:CHEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:SUNG-SEN
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1201 S HACIENDA BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-2237
Mailing Address - Country:US
Mailing Address - Phone:626-855-7911
Mailing Address - Fax:
Practice Address - Street 1:1201 S HACIENDA BLVD STE 201
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-2237
Practice Address - Country:US
Practice Address - Phone:626-855-7911
Practice Address - Fax:626-855-7909
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30209122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist