Healthcare Provider Details

I. General information

NPI: 1831784289
Provider Name (Legal Business Name): D CHIU DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2021
Last Update Date: 03/08/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3361 CLAYTON RD
CONCORD CA
94519-2834
US

IV. Provider business mailing address

2415 SAN RAMON VALLEY BLVD STE 4-831
SAN RAMON CA
94583-5381
US

V. Phone/Fax

Practice location:
  • Phone: 510-969-0788
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER CHIU
Title or Position: CEO
Credential: DDS
Phone: 510-969-0788