Healthcare Provider Details

I. General information

NPI: 1134864382
Provider Name (Legal Business Name): THOMAS CHAE DDS, MS & SOPHIA HUYNH, DDS, MS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2022
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

989 SOUTH BLVD E STE 110
ROCHESTER HILLS MI
48307-5358
US

IV. Provider business mailing address

989 SOUTH BLVD E STE 110
ROCHESTER HILLS MI
48307-5358
US

V. Phone/Fax

Practice location:
  • Phone: 248-243-8811
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS CHAE
Title or Position: ORTHODONTIST
Credential: DDS
Phone: 410-279-2810