Provider Demographics
NPI:1417784448
Name:CHIN, JAEMIN (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:JAEMIN
Middle Name:
Last Name:CHIN
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 3RD AVE APT 15C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-2333
Mailing Address - Country:US
Mailing Address - Phone:412-577-8958
Mailing Address - Fax:
Practice Address - Street 1:344 3RD AVE APT 15C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-2333
Practice Address - Country:US
Practice Address - Phone:412-577-8958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0642991223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics