MEDICARE: WEI-TZE CHEN, P.C.

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	1223E0200X	Endodontics	S7-51	NV
2	1223E0200X	Endodontics	S7-59	NV
3	1223P0300X	Periodontics	S4-31	NV
4	1223P0300X	Periodontics	S4-53	NV
5	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	S3--121	NV

General Provider Information

NPI Number	:	1376712240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEI-TZE CHEN, P.C.

Provider Business Mailing Address
First Line	:	6018 S FORT APACHE RD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5611
Country	:	US
Telephone Number	:	702-547-9977
Fax Number	:	702-547-9982

Provider Business Practice Location Address
First Line	:	6018 S FORT APACHE RD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5611
Country	:	US
Telephone Number	:	702-547-9977
Fax Number	:	702-547-9982

Authorized Official
Title or Position	:	ORTHODONTIST
Name	:	DR. VICTORIA WT CHEN
Credential	:	DDS,MS
Telephone Number	:	702-547-9977

Provider Enumeration Date	:	02/26/2008
Last Update Date	:	02/26/2008

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