Provider Demographics
NPI:1336244938
Name:CHEW, STEVEN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:CHEW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4430 WILLOW RD STE J
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588
Mailing Address - Country:US
Mailing Address - Phone:925-462-0010
Mailing Address - Fax:925-463-3714
Practice Address - Street 1:4430 WILLOW RD STE J
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588
Practice Address - Country:US
Practice Address - Phone:925-462-0010
Practice Address - Fax:925-463-3714
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA338931223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33893OtherSTATE LICENSE NUMBER
CA541291OtherUNITED CONCORDIA