Provider Demographics
NPI:1659491967
Name:CHA, JENNY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JENNY
Middle Name:
Last Name:CHA
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 1:380 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3524
Mailing Address - Country:US
Mailing Address - Phone:203-795-4748
Mailing Address - Fax:203-891-8255
Practice Address - Street 1:380 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3524
Practice Address - Country:US
Practice Address - Phone:203-795-4748
Practice Address - Fax:203-891-8255
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052605122300000X
NJ22DI02313000122300000X
CT010030122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist