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General NPI Number Information
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NPI Number | 1124151592
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Entity Type | Individual
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Provider Name | JUDITH RENEE CHIN DDS, MS
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Gender | Female
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 819 NE 26TH ST
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City | WILTON MANORS
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State | FL
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Zip | 33305-1239
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Country | US
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Telephone | 954-262-7663
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Fax | 954-262-1782
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Provider Business Mailing Address
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Address Line | 3300 S UNIVERSITY DR RM 4317
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City | FT LAUDERDALE
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State | FL
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Zip | 33328-2004
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Country | US
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Telephone | 954-262-7663
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Fax | 954-262-1782
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 12009724
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 47207
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN24018
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License Number State | FL
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