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NPI Code Detail

MEDICARE: DR. CHEN YUAN D.M.D.

MEDICARE:  DR. CHEN  YUAN  D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist6252AZ

General Provider Information

NPI Number : 1043232929
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHEN YUAN D.M.D.
Provider Business Mailing Address
First Line : 6605 N 19TH AVE STE F
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-1628
Country : US
Telephone Number : 602-995-6041
Fax Number : 602-995-1676
Provider Business Practice Location Address
First Line : 6605 N 19TH AVE STE F
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-1628
Country : US
Telephone Number : 602-995-6041
Fax Number : 602-995-1676
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2006
Last Update Date : 07/08/2007

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Directions to “ DR. CHEN YUAN D.M.D.” Practice Location

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