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NPI 1609559863

NPI 1609559863 : JIMMIE CHEN DMD PLLC : AUSTIN, TX

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General NPI Number Information
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    NPI Number           |    1609559863
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    Entity Type          |    Organization 
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    Legal Business Name  |    JIMMIE CHEN DMD PLLC 
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Dates
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    Enumeration Date     |    08/14/2023
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    Last Update Date     |    08/23/2023
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Provider Practice Location Address
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    Address Line         |    4213 BURNET RD STE B 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78756-3316
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    Country              |    US
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    Telephone            |    512-454-9691
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4213 BURNET RD STE B 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78756-3316
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DENTIST
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    Name                 |    DR. JIMMIE  CHEN 
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    Credential           |    DMD
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    Telephone            |    832-866-3363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    
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    License Number State |    
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