Healthcare Provider Details

I. General information

NPI: 1922084235
Provider Name (Legal Business Name): HUA ALLEN CHEN DDS MSD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 04/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 S RENTON VILLAGE PL STE 610
RENTON WA
98057-3287
US

IV. Provider business mailing address

555 S RENTON VILLAGE PL STE 610
RENTON WA
98057-3287
US

V. Phone/Fax

Practice location:
  • Phone: 425-271-5812
  • Fax: 425-226-7448
Mailing address:
  • Phone: 425-271-5812
  • Fax: 425-226-7448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number7986
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: