Provider Demographics
NPI:1245006303
Name:MJYJ INC
Entity type:Organization
Organization Name:MJYJ INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/INCORPORATOR
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:W
Authorized Official - Last Name:JIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:404-518-9012
Mailing Address - Street 1:65 OAK HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2312
Mailing Address - Country:US
Mailing Address - Phone:404-518-9012
Mailing Address - Fax:
Practice Address - Street 1:65 OAK HILL BLVD
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2312
Practice Address - Country:US
Practice Address - Phone:404-518-9012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty