Provider Demographics
NPI:1811185648
Name:CHEN, JIANYE (DDS)
Entity Type:Individual
Prefix:
First Name:JIANYE
Middle Name:
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 1:4302 MOORPARK AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-2030
Mailing Address - Country:US
Mailing Address - Phone:510-230-7599
Mailing Address - Fax:408-255-2011
Practice Address - Street 1:34924 BELVEDERE TER
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94555-3207
Practice Address - Country:US
Practice Address - Phone:510-230-7599
Practice Address - Fax:408-255-2011
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55978122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist