Healthcare Provider Details

I. General information

NPI: 1841683901
Provider Name (Legal Business Name): CHRIS M CHUI DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2015
Last Update Date: 08/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39275 CEDAR BLVD
NEWARK CA
94560-5007
US

IV. Provider business mailing address

43575 MISSION BLVD # 525
FREMONT CA
94539-5831
US

V. Phone/Fax

Practice location:
  • Phone: 510-608-5810
  • 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