Provider Demographics
NPI:1881732360
Name:CHINATOWN DENTAL CLINIC
Entity type:Organization
Organization Name:CHINATOWN DENTAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:213-680-8770
Mailing Address - Street 1:633 N SPRING ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2814
Mailing Address - Country:US
Mailing Address - Phone:213-680-8770
Mailing Address - Fax:213-680-8760
Practice Address - Street 1:633 N SPRING ST STE 1
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2814
Practice Address - Country:US
Practice Address - Phone:213-680-8770
Practice Address - Fax:213-680-8760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty