Provider Demographics
NPI:1912119470
Name:CHEN, TONI (DDS)
Entity Type:Individual
Prefix:DR
First Name:TONI
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 1:8204 HUNTINGTON DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91775-1053
Mailing Address - Country:US
Mailing Address - Phone:626-975-6413
Mailing Address - Fax:626-445-4588
Practice Address - Street 1:8204 HUNTINGTON DR
Practice Address - Street 2:SUITE B
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91775-1053
Practice Address - Country:US
Practice Address - Phone:626-975-6413
Practice Address - Fax:626-445-4588
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA532001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA53200OtherSTATE DENTAL LICENSE