Provider Demographics
NPI:1952936122
Name:WEN-CHI TAKADA DDS,PC
Entity Type:Organization
Organization Name:WEN-CHI TAKADA DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WEN-CHI
Authorized Official - Middle Name:
Authorized Official - Last Name:TAKADA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-344-1000
Mailing Address - Street 1:43155 MAIN ST STE 2312
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1781
Mailing Address - Country:US
Mailing Address - Phone:248-344-1000
Mailing Address - Fax:248-349-3995
Practice Address - Street 1:43155 MAIN ST STE 2312
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1781
Practice Address - Country:US
Practice Address - Phone:248-344-1000
Practice Address - Fax:248-349-3995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental