Provider Demographics
NPI:1760681134
Name:CHEN, CHRIS W (DMD, MPH)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:W
Last Name:CHEN
Suffix:
Gender:M
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15446 BEL RED RD STE 300
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5507
Mailing Address - Country:US
Mailing Address - Phone:425-883-3399
Mailing Address - Fax:425-883-3391
Practice Address - Street 1:15446 BEL RED RD STE 300
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5507
Practice Address - Country:US
Practice Address - Phone:425-883-3399
Practice Address - Fax:425-883-3391
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 600733261223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry