Provider Demographics
NPI:1346313764
Name:CHEN, JUNG-HSIANG (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUNG-HSIANG
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:JUNG-HSIANG
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:2118 S HACIENDA BLVD
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-4242
Mailing Address - Country:US
Mailing Address - Phone:626-333-1672
Mailing Address - Fax:626-333-1672
Practice Address - Street 1:2118 S HACIENDA BLVD
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-4242
Practice Address - Country:US
Practice Address - Phone:626-333-1672
Practice Address - Fax:626-333-1672
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA405591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice