Provider Demographics
NPI:1669033593
Name:HE, JING (DDS)
Entity Type:Individual
Prefix:
First Name:JING
Middle Name:
Last Name:HE
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 1:5416 BASSWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-4400
Mailing Address - Country:US
Mailing Address - Phone:817-656-1215
Mailing Address - Fax:877-230-8349
Practice Address - Street 1:805 164TH ST SE STE 200
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-6316
Practice Address - Country:US
Practice Address - Phone:425-745-6310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-21
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA611306741223G0001X
TX351901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice