Provider Demographics
NPI:1811368590
Name:ZHU, JESSICA (DDS)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ZHU
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 1:24459 SAINT IVES CT
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-4354
Mailing Address - Country:US
Mailing Address - Phone:909-576-5483
Mailing Address - Fax:
Practice Address - Street 1:6071 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2525
Practice Address - Country:US
Practice Address - Phone:951-680-1777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-07
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65150122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist