Provider Demographics
NPI:1699060293
Name:JARDINE, DINCHEN ANNA (MD)
Entity type:Individual
Prefix:DR
First Name:DINCHEN
Middle Name:ANNA
Last Name:JARDINE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 PENNSYLVANIA AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-3389
Mailing Address - Country:US
Mailing Address - Phone:304-388-2980
Mailing Address - Fax:304-388-2981
Practice Address - Street 1:830 PENNSYLVANIA AVE STE 204
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-3389
Practice Address - Country:US
Practice Address - Phone:304-388-2980
Practice Address - Fax:304-388-6445
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101252383207Y00000X
VA0116024205208D00000X
WV33573207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice