Provider Demographics
NPI:1861611428
Name:CHAU, RICHARD LI (DMD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LI
Last Name:CHAU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 S 38TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-1125
Mailing Address - Country:US
Mailing Address - Phone:402-926-6134
Mailing Address - Fax:
Practice Address - Street 1:985180 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-5180
Practice Address - Country:US
Practice Address - Phone:402-559-6445
Practice Address - Fax:402-559-4920
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE65671223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery