Provider Demographics
NPI:1336450998
Name:CHEN, STEPHEN JOSEPH (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:CHEN
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11455 FALLBROOK DR
Mailing Address - Street 2:#201
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4238
Mailing Address - Country:US
Mailing Address - Phone:832-237-4746
Mailing Address - Fax:281-890-4862
Practice Address - Street 1:11455 FALLBROOK DR
Practice Address - Street 2:#201
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4238
Practice Address - Country:US
Practice Address - Phone:832-237-4746
Practice Address - Fax:281-890-4862
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX256551223G0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice