Provider Demographics
NPI:1164700266
Name:SHENG, JIANGYUN (DMD)
Entity Type:Individual
Prefix:
First Name:JIANGYUN
Middle Name:
Last Name:SHENG
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 1:35 NORTHAMPTON ST APT 2003
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-4020
Mailing Address - Country:US
Mailing Address - Phone:617-279-3719
Mailing Address - Fax:
Practice Address - Street 1:159 SAMOSET ST
Practice Address - Street 2:SUITE 5
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4815
Practice Address - Country:US
Practice Address - Phone:508-746-4456
Practice Address - Fax:508-927-2055
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH038531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice