Judith Renee Chin, DDS, MS

Individual provider Active NPI Pediatric Dentistry · Wilton Manors, FL

NPI 1124151592 · NPPES record last updated Mar 27, 2025

Key facts

NPI
1124151592
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Dentistry 1223P0221X
License
DN24018 (FL)
Practice address
819 NE 26TH St
Wilton Manors, FL 33305-1239
Phone
(954) 262-7663
Fax
(954) 262-1782
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
47207CAMDPediatric Dentist
DN24018FLMDPediatric Dentist
12009724INMDPediatric Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 12009724 IN
Pediatric Dentistry 1223P0221X 47207 CA
Pediatric Dentistry 1223P0221X DN24018 FL Yes

Addresses

Primary practice location

819 NE 26TH St
Wilton Manors, FL 33305-1239

Mailing address

3300 S University Dr RM 4317
Ft Lauderdale, FL 33328-2004
Phone (954) 262-7663

Other providers in Wilton Manors, FL

All providers in Wilton Manors, FL · Pediatric Dentistry in Florida

Sources for this page

Verify at the official NPI Registry.