Provider Demographics
NPI:1720349400
Name:CHIN, HAEMIN (DMD)
Entity Type:Individual
Prefix:
First Name:HAEMIN
Middle Name:
Last Name:CHIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 3RD AVE APT 15C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-2333
Mailing Address - Country:US
Mailing Address - Phone:412-897-2478
Mailing Address - Fax:
Practice Address - Street 1:344 3RD AVE APT 15C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-2333
Practice Address - Country:US
Practice Address - Phone:412-897-2478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.032488122300000X
NY0566421223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist