Provider Demographics
NPI:1528362993
Name:ZENG, JIN
Entity Type:Individual
Prefix:
First Name:JIN
Middle Name:
Last Name:ZENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:673 ROBESON ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5425
Mailing Address - Country:US
Mailing Address - Phone:508-676-8268
Mailing Address - Fax:
Practice Address - Street 1:673 ROBESON ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5425
Practice Address - Country:US
Practice Address - Phone:508-676-8268
Practice Address - Fax:508-677-4929
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1855600122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist