Healthcare Provider Details

I. General information

NPI: 1972608370
Provider Name (Legal Business Name): DR. CINDY HONG LY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CINDY LY CHAC DDS

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 OLD TELEGRAPH CANYON RD
CHULA VISTA CA
91910-6587
US

IV. Provider business mailing address

660 OLD TELEGRAPH CANYON RD
CHULA VISTA CA
91910-6587
US

V. Phone/Fax

Practice location:
  • Phone: 909-689-9279
  • Fax:
Mailing address:
  • Phone: 909-689-9279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number54014
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: