Healthcare Provider Details

I. General information

NPI: 1265507099
Provider Name (Legal Business Name): MEELIN DIAN CHIN KIT-WELLS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIAN WELLS DDS

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4550 E BELL RD STE 106
PHOENIX AZ
85032-9342
US

IV. Provider business mailing address

20 S STONE AVE APT 215
TUCSON AZ
85701-0003
US

V. Phone/Fax

Practice location:
  • Phone: 602-344-9530
  • Fax:
Mailing address:
  • Phone: 928-202-0060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number045762-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberD012556
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberD008144
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: