Provider Demographics
NPI:1629283403
Name:JANG, HELEN MI (DDS)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:MI
Last Name:JANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8811 OOLTEWAH GEORGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363
Mailing Address - Country:US
Mailing Address - Phone:423-774-0494
Mailing Address - Fax:253-983-1125
Practice Address - Street 1:3918 TENNESSEE AVE
Practice Address - Street 2:STE 300
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37409
Practice Address - Country:US
Practice Address - Phone:423-821-9771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010512122300000X
TN10946122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003290862AMedicaid