Provider Demographics
NPI:1467682823
Name:JAW, SHIOW JIIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHIOW JIIN
Middle Name:
Last Name:JAW
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MRS
Other - First Name:HSIU CHIN
Other - Middle Name:
Other - Last Name:CHAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:2848 CUMBERLAND RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-2204
Mailing Address - Country:US
Mailing Address - Phone:617-817-2037
Mailing Address - Fax:626-535-0688
Practice Address - Street 1:9428 VALLEY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1514
Practice Address - Country:US
Practice Address - Phone:626-788-9008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA383041223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry