Provider Demographics
NPI:1992917645
Name:CHING, JASON STUART (DDS)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:STUART
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 1:15218 SUMMIT AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-0232
Mailing Address - Country:US
Mailing Address - Phone:909-333-6875
Mailing Address - Fax:951-308-2637
Practice Address - Street 1:15218 SUMMIT AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-0232
Practice Address - Country:US
Practice Address - Phone:909-333-6875
Practice Address - Fax:951-308-2637
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53202122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist