MEDICARE: LUCY CHEN DDS

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
1	1223G0001X	General Practice Dentistry	DT-1918	HI

General Provider Information

NPI Number	:	1154688067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCY CHEN DDS

Provider Business Mailing Address
First Line	:	45-1151 KAMEHAMEHA HWY
Second Line	:	SUITE C
City	:	KANEOHE
State	:	HI
Zip	:	96744-3211
Country	:	US
Telephone Number	:	808-247-1144
Fax Number	:

Provider Business Practice Location Address
First Line	:	45-1151 KAMEHAMEHA HWY
Second Line	:	SUITE C
City	:	KANEOHE
State	:	HI
Zip	:	96744-3211
Country	:	US
Telephone Number	:	808-247-1144
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2012
Last Update Date	:	04/16/2012

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