Basic Information
| Provider Information | |||||||||
| NPI: | 1548915655 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JAMES CHAU DENTAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1133 CAMELBACK ST | ||||||||
| Address2: | #7583 | ||||||||
| City: | NEWPORT BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8584050062 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2503 EASTBLUFF DR STE 101&102 | ||||||||
| Address2: | |||||||||
| City: | NEWPORT BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926603505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9496449211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2022 | ||||||||
| LastUpdateDate: | 03/04/2022 | ||||||||
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| AuthorizedOfficialLastName: | CHAU | ||||||||
| AuthorizedOfficialFirstName: | LONG-GIANG | ||||||||
| AuthorizedOfficialMiddleName: | NGUYEN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9496449211 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DDS | ||||||||
| NPICertificationDate: | 03/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QD0000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Dental |
No ID Information.