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General NPI Number Information
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NPI Number | 1356529275
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Entity Type | Individual
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Provider Name | VIVIAN HUI-WEN CHAN D.D.S., M.S.
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Gender | Female
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Dates
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Enumeration Date | 02/01/2008
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Last Update Date | 06/07/2013
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Provider Practice Location Address
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Address Line | 1830 41ST AVE
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City | CAPITOLA
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State | CA
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Zip | 95010-2505
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Country | US
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Telephone | 831-426-4344
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Fax | 831-426-5223
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Provider Business Mailing Address
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Address Line | 1830 41ST AVE
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City | CAPITOLA
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State | CA
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Zip | 95010-2505
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Country | US
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Telephone | 831-426-4344
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Fax | 831-426-5223
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 55556
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License Number State | CA
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