Provider Demographics
NPI:1376708875
Name:CHIANG, JAMES P (JAMES CHIANG DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:CHIANG
Suffix:
Gender:M
Credentials:JAMES CHIANG DDS
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:P
Other - Last Name:CHIANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JAMES CHIANG DDS
Mailing Address - Street 1:106 19TH AVE
Mailing Address - Street 2:SUITE #90
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-3700
Mailing Address - Country:US
Mailing Address - Phone:309-277-6567
Mailing Address - Fax:309-764-1402
Practice Address - Street 1:106 19TH AVE
Practice Address - Street 2:SUITE #90
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-3700
Practice Address - Country:US
Practice Address - Phone:309-277-6567
Practice Address - Fax:309-764-1402
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0199561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice