Provider Demographics
NPI:1831248061
Name:GIANG, JENNIFER (DMD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:GIANG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 HEMLOCK WAY
Mailing Address - Street 2:SUITE 103A
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-3650
Mailing Address - Country:US
Mailing Address - Phone:714-556-7430
Mailing Address - Fax:
Practice Address - Street 1:1220 HEMLOCK WAY
Practice Address - Street 2:SUITE 103A
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92707-3650
Practice Address - Country:US
Practice Address - Phone:714-556-7430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD389981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD38998OtherDENTI-CAL