Provider Demographics
NPI:1427339183
Name:CHING, JASON ROBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:ROBERT
Last Name:CHING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 KAMEHAMEHA HWY
Mailing Address - Street 2:215
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-2656
Mailing Address - Country:US
Mailing Address - Phone:808-456-4555
Mailing Address - Fax:808-455-6180
Practice Address - Street 1:850 KAMEHAMEHA HWY
Practice Address - Street 2:215
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-2656
Practice Address - Country:US
Practice Address - Phone:808-456-4555
Practice Address - Fax:808-455-6180
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60833122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist