Provider Demographics
NPI:1689939167
Name:JASON S. CHING D.D.S., INC.
Entity Type:Organization
Organization Name:JASON S. CHING D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-333-6875
Mailing Address - Street 1:15218 SUMMIT AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-0232
Mailing Address - Country:US
Mailing Address - Phone:909-333-6875
Mailing Address - Fax:951-308-2637
Practice Address - Street 1:15218 SUMMIT AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-0232
Practice Address - Country:US
Practice Address - Phone:909-333-6875
Practice Address - Fax:951-308-2637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-10
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA532021223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty