Provider Demographics
NPI:1750509899
Name:CHIU, CHINJIP C (DDS)
Entity Type:Individual
Prefix:
First Name:CHINJIP
Middle Name:C
Last Name:CHIU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:HENRY
Other - Middle Name:C
Other - Last Name:CHIU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:7023 HARROW ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5153
Mailing Address - Country:US
Mailing Address - Phone:718-268-3527
Mailing Address - Fax:718-268-8360
Practice Address - Street 1:8 CHATHAM SQ
Practice Address - Street 2:RM 503
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1000
Practice Address - Country:US
Practice Address - Phone:212-385-8080
Practice Address - Fax:212-385-8082
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031074122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00358549Medicaid