Provider Demographics
NPI:1770798456
Name:CHI, KAI ZU (DMD, MSED, MD)
Entity type:Individual
Prefix:DR
First Name:KAI
Middle Name:ZU
Last Name:CHI
Suffix:
Gender:F
Credentials:DMD, MSED, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 SOUTH ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1514
Mailing Address - Country:US
Mailing Address - Phone:267-437-7540
Mailing Address - Fax:267-437-7541
Practice Address - Street 1:1740 SOUTH ST
Practice Address - Street 2:SUITE 302
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1514
Practice Address - Country:US
Practice Address - Phone:267-437-7540
Practice Address - Fax:267-437-7541
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS035784122300000X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist