MEDICARE: JESSICA YIH-WEN NIEN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	44234	CA

General Provider Information

NPI Number	:	1659375988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA YIH-WEN NIEN D.D.S.

Provider Business Mailing Address
First Line	:	991 MONTAGUE EXPY
Second Line	:	SUITE #108
City	:	MILPITAS
State	:	CA
Zip	:	95035-6818
Country	:	US
Telephone Number	:	408-262-8747
Fax Number	:	408-262-8009

Provider Business Practice Location Address
First Line	:	991 MONTAGUE EXPY
Second Line	:	SUITE #108
City	:	MILPITAS
State	:	CA
Zip	:	95035-6818
Country	:	US
Telephone Number	:	408-262-8747
Fax Number	:	408-262-8009

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	07/08/2007

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