Provider Demographics
NPI: | 1174781942 |
---|---|
Name: | CHLOE CHU, D.D.S., A.P.C. |
Entity type: | Organization |
Organization Name: | CHLOE CHU, D.D.S., A.P.C. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | C.E.O. |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | CHLOE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CHU |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DDS |
Authorized Official - Phone: | 408-894-8135 |
Mailing Address - Street 1: | 3720 N 1ST ST |
Mailing Address - Street 2: | SUITE C |
Mailing Address - City: | SAN JOSE |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 95134-1716 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 408-894-8135 |
Mailing Address - Fax: | 408-894-8149 |
Practice Address - Street 1: | 3720 N 1ST ST |
Practice Address - Street 2: | SUITE C |
Practice Address - City: | SAN JOSE |
Practice Address - State: | CA |
Practice Address - Zip Code: | 95134-1716 |
Practice Address - Country: | US |
Practice Address - Phone: | 408-894-8135 |
Practice Address - Fax: | 408-894-8149 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-05-29 |
Last Update Date: | 2008-05-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | 42288 | 1223G0001X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 1223G0001X | Dental Providers | Dentist | General Practice | Group - Multi-Specialty |