Provider Demographics
NPI:1801819644
Name:CHEN, JANE JIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:JIAN
Last Name:CHEN
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 1:4715 STATESMEN DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-5642
Mailing Address - Country:US
Mailing Address - Phone:317-578-9696
Mailing Address - Fax:317-578-9797
Practice Address - Street 1:4715 STATESMEN DR
Practice Address - Street 2:SUITE E
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-5642
Practice Address - Country:US
Practice Address - Phone:317-578-9696
Practice Address - Fax:317-578-9797
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010255A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice