Healthcare Provider Details

I. General information

NPI: 1316172034
Provider Name (Legal Business Name): JOEY CHOU-YIE CHEN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CHOU YIE CHEN D.D.S.

II. Dates (important events)

Enumeration Date: 05/26/2009
Last Update Date: 06/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 COUNTY ROAD 83
CANBY CA
96015
US

IV. Provider business mailing address

670 COUNTY ROAD 83
CANBY CA
96015
US

V. Phone/Fax

Practice location:
  • Phone: 510-427-6028
  • Fax:
Mailing address:
  • Phone: 510-427-6028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number58286
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: