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General NPI Number Information
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NPI Number | 1568838449
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Entity Type | Individual
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Provider Name | CHEN SHI
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Gender | Female
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Dates
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Enumeration Date | 08/14/2015
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 235 GLENVILLE RD STE 2
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City | GREENWICH
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State | CT
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Zip | 06831-4162
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Country | US
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Telephone | 203-531-5595
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Fax |
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Provider Business Mailing Address
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Address Line | 650 LINCOLN ST
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City | WORCESTER
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State | MA
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Zip | 01605-2060
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Country | US
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Telephone | 508-595-1115
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 060913-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12948
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License Number State | CT
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