Provider Demographics
NPI:1760039606
Name:KENNTH J. JACOBS, DDS, INC., AND K. J. LIANG, DDS, INC., A CALIFORNIA
Entity Type:Organization
Organization Name:KENNTH J. JACOBS, DDS, INC., AND K. J. LIANG, DDS, INC., A CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-657-0411
Mailing Address - Street 1:8641 WILSHIRE BLVD STE 315
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2921
Mailing Address - Country:US
Mailing Address - Phone:310-657-0411
Mailing Address - Fax:
Practice Address - Street 1:8641 WILSHIRE BLVD STE 315
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2921
Practice Address - Country:US
Practice Address - Phone:310-657-0411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty