Provider Demographics
NPI:1699441295
Name:MAI, JENNY (DDS)
Entity type:Individual
Prefix:DR
First Name:JENNY
Middle Name:
Last Name:MAI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5016 BRYAN ST APT 104
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-8627
Mailing Address - Country:US
Mailing Address - Phone:520-245-0241
Mailing Address - Fax:
Practice Address - Street 1:13309 MONTFORT DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-5116
Practice Address - Country:US
Practice Address - Phone:469-290-0609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37757122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist