Provider Demographics
NPI:1205084811
Name:SCHOON-TONG, JENNIFER GEE (DDS)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:GEE
Last Name:SCHOON-TONG
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 1:345 ESTUDILLO AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4702
Mailing Address - Country:US
Mailing Address - Phone:510-483-2164
Mailing Address - Fax:
Practice Address - Street 1:345 ESTUDILLO AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4702
Practice Address - Country:US
Practice Address - Phone:510-483-2164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57463122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist