Provider Demographics
NPI:1871612374
Name:CHEN, WEN (DMD, PHD)
Entity type:Individual
Prefix:DR
First Name:WEN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:DMD, PHD
Other - Prefix:DR
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD, PHD
Mailing Address - Street 1:3001 BROWN TRL
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-3204
Mailing Address - Country:US
Mailing Address - Phone:817-581-4031
Mailing Address - Fax:817-581-0892
Practice Address - Street 1:3001 BROWN TRL
Practice Address - Street 2:SUITE 101
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-3204
Practice Address - Country:US
Practice Address - Phone:817-581-4031
Practice Address - Fax:817-581-0892
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX231581223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics