Provider Demographics
NPI:1801049192
Name:CHEN, XIAOYAN (DDS)
Entity type:Individual
Prefix:DR
First Name:XIAOYAN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 SAN PABLO AVE APT B
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-2054
Mailing Address - Country:US
Mailing Address - Phone:510-524-8683
Mailing Address - Fax:510-524-8454
Practice Address - Street 1:914 SAN PABLO AVE APT B
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-2054
Practice Address - Country:US
Practice Address - Phone:510-524-8683
Practice Address - Fax:510-524-8454
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46569122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist