Provider Demographics
NPI:1023679339
Name:MA, CLARE CHENGQIN (DMD)
Entity type:Individual
Prefix:
First Name:CLARE
Middle Name:CHENGQIN
Last Name:MA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 APACHE AVE
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-4738
Mailing Address - Country:US
Mailing Address - Phone:978-886-3170
Mailing Address - Fax:
Practice Address - Street 1:19703 1ST AVE S
Practice Address - Street 2:
Practice Address - City:NORMANDY PARK
Practice Address - State:WA
Practice Address - Zip Code:98148-2401
Practice Address - Country:US
Practice Address - Phone:206-466-3808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH045011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice