Provider Demographics
NPI:1770964181
Name:KALVIN CHEN D.D.S. INC.
Entity type:Organization
Organization Name:KALVIN CHEN D.D.S. INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-529-3184
Mailing Address - Street 1:903 SOUTH BREA BLVD.
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5315
Mailing Address - Country:US
Mailing Address - Phone:714-529-3184
Mailing Address - Fax:
Practice Address - Street 1:903 SOUTH BREA BLVD.
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5315
Practice Address - Country:US
Practice Address - Phone:714-529-3184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41370122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty