Provider Demographics
NPI:1871604041
Name:TOM T.P. CHEN D.D.S.,INC
Entity type:Organization
Organization Name:TOM T.P. CHEN D.D.S.,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:TP
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-375-2436
Mailing Address - Street 1:16900 GOLDENWEST ST
Mailing Address - Street 2:STE. A
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-8405
Mailing Address - Country:US
Mailing Address - Phone:714-375-2436
Mailing Address - Fax:
Practice Address - Street 1:16900 GOLDENWEST ST
Practice Address - Street 2:STE. A
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-8405
Practice Address - Country:US
Practice Address - Phone:714-375-2436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA269671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty