Healthcare Provider Details

I. General information

NPI: 1851400519
Provider Name (Legal Business Name): JOSEPH J CHEN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11455 FALLBROOK SUITE 302
HOUSTON TX
77065
US

IV. Provider business mailing address

11455 FALLBROOK SUITE 302
HOUSTON TX
77065
US

V. Phone/Fax

Practice location:
  • Phone: 281-890-1158
  • Fax: 281-890-0710
Mailing address:
  • Phone: 281-890-1158
  • Fax: 281-890-0710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number11886
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: