Provider Demographics
NPI:1841585270
Name:CHEN, LILY YUSHENG (DDS)
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:YUSHENG
Last Name:CHEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 EDINBURGH CIR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-2900
Mailing Address - Country:US
Mailing Address - Phone:925-915-1123
Mailing Address - Fax:
Practice Address - Street 1:4101 DUBLIN BLVD
Practice Address - Street 2:SUITE #D
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-4592
Practice Address - Country:US
Practice Address - Phone:925-803-5888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011665A122300000X
CA61214122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist