Healthcare Provider Details

I. General information

NPI: 1558743260
Provider Name (Legal Business Name): CHRIS M CHUI DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2015
Last Update Date: 08/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1328 W EL CAMINO REAL STE 1
MOUNTAIN VIEW CA
94040-2499
US

IV. Provider business mailing address

43575 MISSION BLVD # 525
FREMONT CA
94539-5831
US

V. Phone/Fax

Practice location:
  • Phone: 650-962-8773
  • Fax:
Mailing address:
  • Phone: 408-321-8880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRIS M CHUI
Title or Position: OWNER
Credential: DDS
Phone: 408-321-8880