Provider Demographics
NPI:1275127227
Name:JYZ DDS LLC
Entity Type:Organization
Organization Name:JYZ DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:YIZHOU
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-823-7350
Mailing Address - Street 1:1481 NW 13TH AVE APT 838
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3413
Mailing Address - Country:US
Mailing Address - Phone:626-823-7350
Mailing Address - Fax:
Practice Address - Street 1:4413 SE CESAR E CHAVEZ BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-3117
Practice Address - Country:US
Practice Address - Phone:503-777-2284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-21
Last Update Date:2021-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental