Provider Demographics
NPI:1447271937
Name:CHIEN, PHILLIP J (DDS)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:J
Last Name:CHIEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27699 JEFFERSON AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-2615
Mailing Address - Country:US
Mailing Address - Phone:951-695-1028
Mailing Address - Fax:
Practice Address - Street 1:27699 JEFFERSON AVE STE 309
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-2615
Practice Address - Country:US
Practice Address - Phone:951-695-1028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA461721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice