Provider Demographics
NPI:1023504768
Name:QIAN, JENNIFER JINMEI (DDS)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JINMEI
Last Name:QIAN
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 1:474 48TH AVE APT 3BB
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11109-5602
Mailing Address - Country:US
Mailing Address - Phone:443-928-1350
Mailing Address - Fax:
Practice Address - Street 1:164 W 96TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6402
Practice Address - Country:US
Practice Address - Phone:212-749-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2025-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0636461223G0001X
MD167191223G0001X
VA04014173321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice