Healthcare Provider Details

I. General information

NPI: 1376712240
Provider Name (Legal Business Name): WEI-TZE CHEN, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6018 S FORT APACHE RD STE 100
LAS VEGAS NV
89148-5611
US

IV. Provider business mailing address

6018 S FORT APACHE RD STE 100
LAS VEGAS NV
89148-5611
US

V. Phone/Fax

Practice location:
  • Phone: 702-547-9977
  • Fax: 702-547-9982
Mailing address:
  • Phone: 702-547-9977
  • Fax: 702-547-9982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberS7-51
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberS7-59
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberS4-31
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberS4-53
License Number StateNV
# 5
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberS3--121
License Number StateNV

VIII. Authorized Official

Name: DR. VICTORIA WT CHEN
Title or Position: ORTHODONTIST
Credential: DDS,MS
Phone: 702-547-9977