Healthcare Provider Details

I. General information

NPI: 1568100881
Provider Name (Legal Business Name): XI CHEN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 S EXECUTIVE DR STE 110
BROOKFIELD WI
53005-4204
US

IV. Provider business mailing address

W149N11878 RED HOLLY DR
GERMANTOWN WI
53022-5688
US

V. Phone/Fax

Practice location:
  • Phone: 262-228-4531
  • Fax:
Mailing address:
  • Phone: 713-412-3018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number6001770-15
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number6001770-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: