Provider Demographics
NPI:1841212461
Name:CHEN, CHUN YU YOGI (DMD)
Entity Type:Individual
Prefix:
First Name:CHUN YU
Middle Name:YOGI
Last Name:CHEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3896 N MLK BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-6603
Mailing Address - Country:US
Mailing Address - Phone:508-904-8670
Mailing Address - Fax:702-933-0190
Practice Address - Street 1:10830 W CHARLESTON BLVD STE 130
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-1194
Practice Address - Country:US
Practice Address - Phone:702-268-7132
Practice Address - Fax:725-201-0469
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA186401223X0400X
NVS31771223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics