Provider Demographics
NPI:1841356417
Name:CHIEN, MINGCHUN (DMD)
Entity type:Individual
Prefix:DR
First Name:MINGCHUN
Middle Name:
Last Name:CHIEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 BAKER AVE
Mailing Address - Street 2:SUITE S-200
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-2189
Mailing Address - Country:US
Mailing Address - Phone:978-369-6248
Mailing Address - Fax:
Practice Address - Street 1:290 BAKER AVE
Practice Address - Street 2:SUITE S-200
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2189
Practice Address - Country:US
Practice Address - Phone:978-369-6248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA189771223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0213942Medicaid
MAX07777OtherBLUE CROSS BLUE SHIELD PR