Healthcare Provider Details

I. General information

NPI: 1437839784
Provider Name (Legal Business Name): CHESTER HO YIN CHAN D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2023
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date: 02/28/2024
Reactivation Date: 04/13/2026

III. Provider practice location address

1177 SUMMER ST FL 2
STAMFORD CT
06905-5522
US

IV. Provider business mailing address

1177 SUMMER ST FL 2
STAMFORD CT
06905-5522
US

V. Phone/Fax

Practice location:
  • Phone: 203-327-2540
  • Fax:
Mailing address:
  • Phone: 203-327-2540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number14788
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: