Provider Demographics
NPI:1043389075
Name:CHEN, JAMES JIAN (DDS, PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JIAN
Last Name:CHEN
Suffix:
Gender:M
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7455 EL CAMINO REAL
Mailing Address - Street 2:SUITE K
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-2922
Mailing Address - Country:US
Mailing Address - Phone:510-364-5009
Mailing Address - Fax:
Practice Address - Street 1:7455 EL CAMINO REAL
Practice Address - Street 2:SUITE K
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94014-2922
Practice Address - Country:US
Practice Address - Phone:650-755-0277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA539801223G0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice