Provider Demographics
NPI:1417160151
Name:CHIANG-MCCASLAND, JAMIE A (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:A
Last Name:CHIANG-MCCASLAND
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JAMIE
Other - Middle Name:A
Other - Last Name:CHIANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6555 N MESA ST
Mailing Address - Street 2:N. MESA ST
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-4417
Mailing Address - Country:US
Mailing Address - Phone:915-584-5457
Mailing Address - Fax:915-845-2286
Practice Address - Street 1:6555 N MESA ST
Practice Address - Street 2:N. MESA ST
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4417
Practice Address - Country:US
Practice Address - Phone:915-584-5457
Practice Address - Fax:915-845-2286
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19992122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX162212805Medicaid
TX162212805Medicaid