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NPI Code Detail

MEDICARE: DR. CHANYOUNG SEAN CHI D.D.S.

MEDICARE: DR. CHANYOUNG SEAN CHI D.D.S.
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
11223G0001XGeneral Practice Dentistry54728CA
21223D0001XPublic Health DentistryDEN.00202487CO

General Provider Information

NPI Number : 1891877650
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHANYOUNG SEAN CHI D.D.S.
Provider Business Mailing Address
First Line : 3701 S BROADWAY
Second Line :
City : ENGLEWOOD
State : CO
Zip : 80113-3611
Country : US
Telephone Number : 303-360-6276
Fax Number : 303-467-5355
Provider Business Practice Location Address
First Line : 3292 PEORIA ST
Second Line :
City : AURORA
State : CO
Zip : 80010-1517
Country : US
Telephone Number : 303-343-7277
Fax Number : 303-343-7290
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 12/11/2024

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