Healthcare Provider Details

I. General information

NPI: 1376163097
Provider Name (Legal Business Name): MICHELLE CHEN DMD, MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2020
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 S BEDFORD ST STE 100
BURLINGTON MA
01803-5217
US

IV. Provider business mailing address

77 S BEDFORD ST STE 100
BURLINGTON MA
01803-5217
US

V. Phone/Fax

Practice location:
  • Phone: 781-272-0800
  • Fax:
Mailing address:
  • Phone: 781-272-0800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN10001243
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: