Provider Demographics
NPI:1639375991
Name:CHEN, WILLIAM YEN-JUNG (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:YEN-JUNG
Last Name:CHEN
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 1:2396 BUCKINGHAM LN
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1338
Mailing Address - Country:US
Mailing Address - Phone:714-738-6651
Mailing Address - Fax:
Practice Address - Street 1:259 LAGUNA RD
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-2515
Practice Address - Country:US
Practice Address - Phone:714-738-6651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA458381223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics