Provider Demographics
NPI:1457765943
Name:ANDREW T CHEN, DMD PLLC
Entity Type:Organization
Organization Name:ANDREW T CHEN, DMD PLLC
Other - Org Name:LITTLE BIG SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:T
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:469-200-0544
Mailing Address - Street 1:7333 COIT RD
Mailing Address - Street 2:STE 110
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-4903
Mailing Address - Country:US
Mailing Address - Phone:469-200-0544
Mailing Address - Fax:888-977-2940
Practice Address - Street 1:7333 COIT RD
Practice Address - Street 2:STE 110
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-4903
Practice Address - Country:US
Practice Address - Phone:469-200-0544
Practice Address - Fax:888-977-2940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-12
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24394261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX337365601Medicaid
TX337365602Medicaid