Provider Demographics
NPI:1457373722
Name:JIN, CHIA-FEN CAROL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHIA-FEN
Middle Name:CAROL
Last Name:JIN
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 1:2301 CAMINO RAMON STE 220
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-2029
Mailing Address - Country:US
Mailing Address - Phone:925-355-1112
Mailing Address - Fax:925-355-1036
Practice Address - Street 1:2301 CAMINO RAMON STE 220
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-2029
Practice Address - Country:US
Practice Address - Phone:925-355-1122
Practice Address - Fax:925-355-1036
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50156122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist