Provider Demographics
NPI:1396762092
Name:CHIEN-CHING JUAN, D.M.D., P.C.
Entity type:Organization
Organization Name:CHIEN-CHING JUAN, D.M.D., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIEN-CHING
Authorized Official - Middle Name:
Authorized Official - Last Name:JUAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-385-9992
Mailing Address - Street 1:PO BOX 605
Mailing Address - Street 2:
Mailing Address - City:DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02638-0605
Mailing Address - Country:US
Mailing Address - Phone:508-385-9992
Mailing Address - Fax:508-385-0092
Practice Address - Street 1:800 MAIN ST
Practice Address - Street 2:
Practice Address - City:DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02638-1904
Practice Address - Country:US
Practice Address - Phone:508-385-9992
Practice Address - Fax:508-385-0092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA201781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
01423816OtherUNITED CONCORDIA
MAX12084OtherBLUE CROSS BLUE SHIELD
41873OtherHARVARD PILGRIM