Provider Demographics
NPI:1750591392
Name:KYLEEN J CHEN, D.D.S., P.C.
Entity type:Organization
Organization Name:KYLEEN J CHEN, D.D.S., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-918-0888
Mailing Address - Street 1:6301 W PARMER LN
Mailing Address - Street 2:SUITE 606
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-6801
Mailing Address - Country:US
Mailing Address - Phone:512-918-0888
Mailing Address - Fax:512-918-0886
Practice Address - Street 1:6301 W PARMER LN
Practice Address - Street 2:SUITE 606
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-6801
Practice Address - Country:US
Practice Address - Phone:512-918-0888
Practice Address - Fax:512-918-0886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty