Provider Demographics
NPI:1831278290
Name:WU, JIANN-JANG (BMD, MS)
Entity type:Individual
Prefix:DR
First Name:JIANN-JANG
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:BMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N LAKEMONT AVE
Mailing Address - Street 2:SUITE 2400
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3208
Mailing Address - Country:US
Mailing Address - Phone:407-647-4773
Mailing Address - Fax:407-647-4548
Practice Address - Street 1:201 N LAKEMONT AVE
Practice Address - Street 2:SUITE 2400
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3208
Practice Address - Country:US
Practice Address - Phone:407-647-4773
Practice Address - Fax:407-647-4548
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00115351223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics