MEDICARE: DAVID 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	390200000X	Student in an Organized Health Care Education/Training Program	TD-00-107	NM
2	1223G0001X	General Practice Dentistry	DEN.00203859	CO

General Provider Information

NPI Number	:	1720570088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID CHEN DDS

Provider Business Mailing Address
First Line	:	12191 W 64TH AVE STE 202
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80004-4030
Country	:	US
Telephone Number	:	303-425-6022
Fax Number	:

Provider Business Practice Location Address
First Line	:	12191 W 64TH AVE STE 202
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80004-4030
Country	:	US
Telephone Number	:	303-425-6022
Fax Number	:

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

Provider Enumeration Date	:	06/02/2018
Last Update Date	:	03/16/2020

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Directions to “ DAVID CHEN DDS” Practice Location

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