MEDICARE: DR. ERIC C CHEN DDS, MS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DDS101321	CA

General Provider Information

NPI Number	:	1811351604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC C CHEN DDS, MS

Provider Business Mailing Address
First Line	:	1472 SILVER LAKE BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-1346
Country	:	US
Telephone Number	:	310-405-3155
Fax Number	:

Provider Business Practice Location Address
First Line	:	11600 WILSHIRE BLVD STE 316
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1783
Country	:	US
Telephone Number	:	310-444-4977
Fax Number	:

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

Provider Enumeration Date	:	04/08/2016
Last Update Date	:	05/07/2026

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