Provider Demographics
NPI:1255539698
Name:CHIU, DAVID HUNG-JEN (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HUNG-JEN
Last Name:CHIU
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 1:2102 E TYLER AVE
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7191
Mailing Address - Country:US
Mailing Address - Phone:956-622-4409
Mailing Address - Fax:956-440-8725
Practice Address - Street 1:2102 E TYLER AVE
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7191
Practice Address - Country:US
Practice Address - Phone:956-622-4409
Practice Address - Fax:956-440-8725
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX245031223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX201912701Medicaid