Provider Demographics
NPI:1740568203
Name:CHEN, YANWEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:YANWEN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 MIZE RD SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-5729
Mailing Address - Country:US
Mailing Address - Phone:503-364-7776
Mailing Address - Fax:503-364-4445
Practice Address - Street 1:120 MIZE RD SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-5729
Practice Address - Country:US
Practice Address - Phone:503-364-7776
Practice Address - Fax:503-364-4445
Is Sole Proprietor?:No
Enumeration Date:2011-08-01
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD96091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice