Provider Demographics
NPI:1578851176
Name:PHUI, JENNIE SOI (RDHAP)
Entity Type:Individual
Prefix:
First Name:JENNIE
Middle Name:SOI
Last Name:PHUI
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:JENNIE
Other - Middle Name:HANG-SOI
Other - Last Name:PHUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9877 CHAPMAN AVE STE. D #413
Mailing Address - Street 2:
Mailing Address - City:GARDEN
Mailing Address - State:CA
Mailing Address - Zip Code:92841-3233
Mailing Address - Country:US
Mailing Address - Phone:714-638-8709
Mailing Address - Fax:714-638-8917
Practice Address - Street 1:12562 DALE ST UNIT 30
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-4565
Practice Address - Country:US
Practice Address - Phone:714-583-8165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-16
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist