Provider Demographics
NPI:1245390079
Name:JI, ZHIBIN (DDS)
Entity Type:Individual
Prefix:
First Name:ZHIBIN
Middle Name:
Last Name:JI
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 1:1350 CHURN CREEK RD # F1
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-4087
Mailing Address - Country:US
Mailing Address - Phone:530-224-1524
Mailing Address - Fax:530-224-9637
Practice Address - Street 1:4340 SHASTA DAM BLVD
Practice Address - Street 2:
Practice Address - City:SHASTA LAKE
Practice Address - State:CA
Practice Address - Zip Code:96019-9420
Practice Address - Country:US
Practice Address - Phone:530-275-2910
Practice Address - Fax:530-275-9335
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48470122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist