MEDICARE: ANTHONY S. CHAE PLLC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1972466738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTHONY S. CHAE PLLC

Provider Business Mailing Address
First Line	:	2101 HANDLEY DR STE 5
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-5147
Country	:	US
Telephone Number	:	330-573-0776
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 HANDLEY DR STE 5
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-5147
Country	:	US
Telephone Number	:	330-573-0776
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. ANTHONY CHAE
Credential	:	DDS
Telephone Number	:	330-573-0776

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/11/2025

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