Provider Demographics
NPI:1053298679
Name:PETER CHEN DENTAL PLLC
Entity type:Organization
Organization Name:PETER CHEN DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:347-728-8300
Mailing Address - Street 1:389 E 89TH ST APT 17G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5207
Mailing Address - Country:US
Mailing Address - Phone:347-728-8300
Mailing Address - Fax:
Practice Address - Street 1:3629 BELL BLVD STE 201
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2056
Practice Address - Country:US
Practice Address - Phone:917-740-5779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty