1811204704 NPI number — DR. LINDA CHA MASEK DDS

Table of content: DR. LINDA CHA MASEK DDS (NPI 1811204704)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811204704 NPI number — DR. LINDA CHA MASEK DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHA MASEK
Provider First Name:
LINDA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHA
Provider Other First Name:
LINDA
Provider Other Middle Name:
MEE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1811204704
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5431 LONGVIEW ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75206-5605
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-796-9983
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6336 GREENVILLE AVE STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75206-1303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-483-9783
Provider Business Practice Location Address Fax Number:
972-483-9778
Provider Enumeration Date:
09/13/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  23387 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)