Provider Demographics
NPI:1730638057
Name:CHING-ROO CHI DDS INC
Entity Type:Organization
Organization Name:CHING-ROO CHI DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHING
Authorized Official - Middle Name:ROO
Authorized Official - Last Name:CHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,
Authorized Official - Phone:951-789-6886
Mailing Address - Street 1:2707 E VALLEY BLVD
Mailing Address - Street 2:107
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-3195
Mailing Address - Country:US
Mailing Address - Phone:626-581-1929
Mailing Address - Fax:626-581-1928
Practice Address - Street 1:2707 E VALLEY BLVD
Practice Address - Street 2:107
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-3195
Practice Address - Country:US
Practice Address - Phone:626-581-1929
Practice Address - Fax:626-581-1928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-28
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40066122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty