Provider Demographics
NPI:1821291535
Name:DAI, JIA-CHUN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JIA-CHUN
Middle Name:
Last Name:DAI
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 1:5240 HEMMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-6902
Mailing Address - Country:US
Mailing Address - Phone:216-258-4497
Mailing Address - Fax:
Practice Address - Street 1:5240 HEMMINGTON BLVD
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-6902
Practice Address - Country:US
Practice Address - Phone:216-258-4497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0225231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice