Provider Demographics
NPI:1750515417
Name:QIAN, JING-JING (DDS)
Entity type:Individual
Prefix:DR
First Name:JING-JING
Middle Name:
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 1:1289 E HILLSDALE BLVD
Mailing Address - Street 2:#3
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404-1294
Mailing Address - Country:US
Mailing Address - Phone:650-572-8518
Mailing Address - Fax:650-572-8582
Practice Address - Street 1:1289 E HILLSDALE BLVD
Practice Address - Street 2:#3
Practice Address - City:FOSTER CITY
Practice Address - State:CA
Practice Address - Zip Code:94404-1294
Practice Address - Country:US
Practice Address - Phone:650-572-8518
Practice Address - Fax:650-572-8582
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA503511223G0001X
CACA-503511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice