Provider Demographics
NPI:1619342730
Name:JASON R. CHING DDS LLC
Entity Type:Organization
Organization Name:JASON R. CHING DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-456-4555
Mailing Address - Street 1:850 KAMEHAMEHA HWY
Mailing Address - Street 2:215
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-2656
Mailing Address - Country:US
Mailing Address - Phone:808-456-4555
Mailing Address - Fax:808-455-6180
Practice Address - Street 1:850 KAMEHAMEHA HWY
Practice Address - Street 2:215
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-2656
Practice Address - Country:US
Practice Address - Phone:808-456-4555
Practice Address - Fax:808-455-6180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT2479122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty