Provider Demographics
NPI:1730491440
Name:CHIU, JIEUN (DDS)
Entity Type:Individual
Prefix:
First Name:JIEUN
Middle Name:
Last Name:CHIU
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 1:908 SOUTHMORE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77502-1120
Mailing Address - Country:US
Mailing Address - Phone:713-554-1091
Mailing Address - Fax:713-554-1096
Practice Address - Street 1:908 SOUTHMORE
Practice Address - Street 2:SUITE 100
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502-1120
Practice Address - Country:US
Practice Address - Phone:713-554-1091
Practice Address - Fax:713-554-1096
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice