Provider Demographics
NPI:1770776403
Name:CHEN, EMILY Y (DDS)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:Y
Last Name:CHEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:1505 STONE BRIDGE PKWY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-8252
Mailing Address - Country:US
Mailing Address - Phone:678-810-0881
Mailing Address - Fax:678-810-0882
Practice Address - Street 1:1505 STONE BRIDGE PKWY
Practice Address - Street 2:SUITE 220
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-8252
Practice Address - Country:US
Practice Address - Phone:678-810-0881
Practice Address - Fax:678-810-0882
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2013-06-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GADN0140101223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA314992696AMedicaid
SCZG9079Medicaid
GA1418385OtherUNITED CONCORDIA