Provider Demographics
NPI:1003537945
Name:CHARNG SHING JEAN DENTAL CORPORATION
Entity Type:Organization
Organization Name:CHARNG SHING JEAN DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARNG
Authorized Official - Middle Name:SHING
Authorized Official - Last Name:JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:494-551-4737
Mailing Address - Street 1:4200 TRABUCO RD STE 130
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3622
Mailing Address - Country:US
Mailing Address - Phone:949-551-4737
Mailing Address - Fax:949-551-0180
Practice Address - Street 1:4200 TRABUCO RD STE 130
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-3622
Practice Address - Country:US
Practice Address - Phone:949-551-4737
Practice Address - Fax:949-551-0180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty