MEDICARE: CHIH FONG CHIU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	4161	NV

General Provider Information

NPI Number	:	1437558855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHIH FONG CHIU

Provider Business Mailing Address
First Line	:	6420 SKY POINTE DR STE 170
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-4046
Country	:	US
Telephone Number	:	702-878-3368
Fax Number	:	702-655-2668

Provider Business Practice Location Address
First Line	:	6420 SKY POINTE DR STE 170
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-4046
Country	:	US
Telephone Number	:	702-878-3368
Fax Number	:	702-655-2668

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2014
Last Update Date	:	08/21/2014

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Directions to “ CHIH FONG CHIU ” Practice Location

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