Healthcare Provider Details

I. General information

NPI: 1992341507
Provider Name (Legal Business Name): CYRIL CHOU DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2019
Last Update Date: 10/28/2026
Certification Date: 10/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HALL OF FAME AVE STE 5
SPRINGFIELD MA
01105-2538
US

IV. Provider business mailing address

1000 HALL OF FAME AVE STE 5
SPRINGFIELD MA
01105-2538
US

V. Phone/Fax

Practice location:
  • Phone: 413-295-5988
  • Fax: 413-295-5977
Mailing address:
  • Phone: 413-295-5988
  • Fax: 413-295-5977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1858537
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: