Healthcare Provider Details

I. General information

NPI: 1063147577
Provider Name (Legal Business Name): DAVID CHIAPIN LI DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 W FREMONT AVE STE Q
SUNNYVALE CA
94087-3065
US

IV. Provider business mailing address

990 W FREMONT AVE STE Q
SUNNYVALE CA
94087-3065
US

V. Phone/Fax

Practice location:
  • Phone: 408-738-2030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DAVID C LI
Title or Position: DOCTOR
Credential: DDS
Phone: 408-738-2030