1851491617 NPI number — TRINA H. CHAU, DDS, LTD.

Table of content: (NPI 1851491617)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851491617 NPI number — TRINA H. CHAU, DDS, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRINA H. CHAU, DDS, LTD.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
AMAZING SMILE DENTISTRY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851491617
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/07/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6252 S. RAINBOW BLVD.
Provider Second Line Business Mailing Address:
BLDG. A, STE. 130
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89118
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-734-6252
Provider Business Mailing Address Fax Number:
702-257-6259

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6252 S RAINBOW BLVD
Provider Second Line Business Practice Location Address:
BLDG. A, STE. 130
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89118-3248
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-734-6252
Provider Business Practice Location Address Fax Number:
702-257-6259
Provider Enumeration Date:
09/22/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CHAU
Authorized Official First Name:
TRINA
Authorized Official Middle Name:
H
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
702-734-6252

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  4618 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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