Provider Demographics
NPI:1952635625
Name:CHEN, SHIUANN R (DDS)
Entity Type:Individual
Prefix:
First Name:SHIUANN
Middle Name:R
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 1:182 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3206
Mailing Address - Country:US
Mailing Address - Phone:201-444-1712
Mailing Address - Fax:201-445-0308
Practice Address - Street 1:182 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3206
Practice Address - Country:US
Practice Address - Phone:201-444-1712
Practice Address - Fax:201-445-0308
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ143271223X0400X
NY373191223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics