MEDICARE: DR. SARA CHEN DMD

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	122300000X	Dentist	019030367	IL
2	122300000X	Dentist	34596	TX

General Provider Information

NPI Number	:	1659850691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARA CHEN DMD

Provider Business Mailing Address
First Line	:	12639 COIT RD APT 7201
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75251-1741
Country	:	US
Telephone Number	:	603-521-2362
Fax Number	:

Provider Business Practice Location Address
First Line	:	3878 OAK LAWN AVE STE 310
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-4471
Country	:	US
Telephone Number	:	214-484-1064
Fax Number	:

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

Provider Enumeration Date	:	08/10/2018
Last Update Date	:	07/21/2021

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Directions to “ DR. SARA CHEN DMD” Practice Location

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