Chunhua Chilton Liu
Individual provider Active NPI General Practice Dentistry · Dixon, CA
NPI 1124432695 · NPPES record last updated Nov 2, 2022
Key facts
- NPI
- 1124432695
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 63496 (CA)
- Practice address
- 1285 Stratford Ave Ste a
Dixon, CA 95620-2001 - Phone
- (707) 678-3065
- Fax
- (707) 678-3026
- NPI assigned
- Jun 12, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180226001210 | CO | Order and Referring Only - Dentist |
5698036101 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63496 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chunhua Chilton DDS Inc | Dentist | Current |
Accepting new patients |
| Sheila N Harris, DDS Inc | General Practice | Past |
Accepting new patients |
Locations
1285 Stratford Ave
Ste A
Dixon, CA 95620
Phone (707) 678-3065
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 63496 | CA | Yes |
Addresses
Primary practice location
1285 Stratford Ave Ste a
Dixon, CA 95620-2001
Mailing address
5060 Brimley Way
Sacramento, CA 95835-1616
Phone (909) 353-8291
Other providers in Dixon, CA
- Kristina L. Wiley, DDS, Inc.
- Kristina L. Wiley, DDS, Inc.
- Belen Alejandra Lastra
- Jennifer Lausier
- Sandra D Lee
- Julie Liu
- Ruth Y Liu
- Adrian Aldemaro Loarca
- Ana Ruth Lobo-Smithson
- Angela Lockwood
All providers in Dixon, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.