Provider Demographics
NPI:1790073112
Name:MEEVE CHIE, LEILA (DMD)
Entity Type:Individual
Prefix:
First Name:LEILA
Middle Name:
Last Name:MEEVE CHIE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:LEILA
Other - Middle Name:MEEVE
Other - Last Name:CHIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:617 SONRISA ST
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2437
Mailing Address - Country:US
Mailing Address - Phone:857-636-8032
Mailing Address - Fax:
Practice Address - Street 1:617 SONRISA ST
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2437
Practice Address - Country:US
Practice Address - Phone:857-636-8032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1855681122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA62323OtherSTATE LICENSE