Provider Demographics
NPI:1932489044
Name:CHEN, JIN YUAN (DDS)
Entity Type:Individual
Prefix:MISS
First Name:JIN
Middle Name:YUAN
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 1:9198 BELLAIRE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-4630
Mailing Address - Country:US
Mailing Address - Phone:713-981-6878
Mailing Address - Fax:713-981-8822
Practice Address - Street 1:9198 BELLAIRE BLVD STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4630
Practice Address - Country:US
Practice Address - Phone:713-981-6878
Practice Address - Fax:713-981-8822
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX147651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice