Provider Demographics
NPI:1831745801
Name:KATY CHOU D D S DENTAL CORP
Entity type:Organization
Organization Name:KATY CHOU D D S DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-854-1826
Mailing Address - Street 1:31571 CANYON ESTATES DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-0412
Mailing Address - Country:US
Mailing Address - Phone:626-688-3829
Mailing Address - Fax:
Practice Address - Street 1:31571 CANYON ESTATES DR STE 200
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92532-0412
Practice Address - Country:US
Practice Address - Phone:951-471-8979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty