Provider Demographics
NPI:1710487780
Name:WEBSTER STREET DENTAL PLLC
Entity Type:Organization
Organization Name:WEBSTER STREET DENTAL PLLC
Other - Org Name:ELEVATE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEE EUN
Authorized Official - Middle Name:NAOMI
Authorized Official - Last Name:CHEW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-629-6610
Mailing Address - Street 1:PO BOX 830128
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78283-0128
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:311 E JONES AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215
Practice Address - Country:US
Practice Address - Phone:210-686-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-16
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental