Healthcare Provider Details

I. General information

NPI: 1124950035
Provider Name (Legal Business Name): TIEN THUY CHAU DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7890 E FLORENTINE RD
PRESCOTT VALLEY AZ
86314-1204
US

IV. Provider business mailing address

4824 LA MADERA AVE
EL MONTE CA
91732-1614
US

V. Phone/Fax

Practice location:
  • Phone: 928-772-9860
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD012801
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: