Provider Demographics
NPI:1497113476
Name:J.S.GO,D.D.S., INC.
Entity Type:Organization
Organization Name:J.S.GO,D.D.S., INC.
Other - Org Name:HACIENDA SMILE DESIGN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-968-9601
Mailing Address - Street 1:161 S HACIENDA BLVD
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91745-1102
Mailing Address - Country:US
Mailing Address - Phone:626-968-9601
Mailing Address - Fax:626-968-9603
Practice Address - Street 1:161 S HACIENDA BLVD
Practice Address - Street 2:
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91745-1102
Practice Address - Country:US
Practice Address - Phone:626-968-9601
Practice Address - Fax:626-968-9603
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27286122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty