Healthcare Provider Details

I. General information

NPI: 1609096502
Provider Name (Legal Business Name): MAY CHEN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 11/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 MAGUIRE RD STE 159
WINDERMERE FL
34786-7924
US

IV. Provider business mailing address

1805 MAGUIRE RD STE 159
WINDERMERE FL
34786-7924
US

V. Phone/Fax

Practice location:
  • Phone: 407-876-6708
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN 15276
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: