Provider Demographics
NPI:1821142423
Name:JUAN, CHIEN-CHING (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHIEN-CHING
Middle Name:
Last Name:JUAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 605
Mailing Address - Street 2:
Mailing Address - City:DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02638-0605
Mailing Address - Country:US
Mailing Address - Phone:508-385-9992
Mailing Address - Fax:
Practice Address - Street 1:800 MAIN ST
Practice Address - Street 2:
Practice Address - City:DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02638-1904
Practice Address - Country:US
Practice Address - Phone:508-385-9992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA201781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA01423816OtherUNITED CONCORDIA
MA41873OtherHARVARD PILGRIM
MAX12084OtherBLUE CROSS BLUE SHIELD