Provider Demographics
NPI:1093544561
Name:JENNIFER CHIANG, DDS, INC
Entity type:Organization
Organization Name:JENNIFER CHIANG, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-523-4030
Mailing Address - Street 1:201 HOCKNEY AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94041-1684
Mailing Address - Country:US
Mailing Address - Phone:408-523-4030
Mailing Address - Fax:
Practice Address - Street 1:333 W MAUDE AVE STE 107
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-4367
Practice Address - Country:US
Practice Address - Phone:408-523-4030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty