Provider Demographics
NPI:1295132520
Name:CHEN, JINGYA JEANNE (OD)
Entity type:Individual
Prefix:DR
First Name:JINGYA
Middle Name:JEANNE
Last Name:CHEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:3316 SILAS CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3011
Mailing Address - Country:US
Mailing Address - Phone:336-765-5350
Mailing Address - Fax:336-765-0769
Practice Address - Street 1:1600 HIGHWOODS BLVD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2048
Practice Address - Country:US
Practice Address - Phone:336-297-4731
Practice Address - Fax:336-297-4736
Is Sole Proprietor?:No
Enumeration Date:2014-12-02
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2406152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management