Provider Demographics
NPI:1689848731
Name:RONG, JENNY CHEN
Entity Type:Individual
Prefix:DR
First Name:JENNY
Middle Name:CHEN
Last Name:RONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 BRIDGE ST BLDG D
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2290
Mailing Address - Country:US
Mailing Address - Phone:732-321-3390
Mailing Address - Fax:
Practice Address - Street 1:203 BRIDGE ST BLDG D
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2290
Practice Address - Country:US
Practice Address - Phone:732-321-3390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-19
Last Update Date:2008-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DJ022046001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics