Healthcare Provider Details

I. General information

NPI: 1457370322
Provider Name (Legal Business Name): CHRISTOPHER HENRY JEN KIN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

669 CRESPI DR STE F
PACIFICA CA
94044
US

IV. Provider business mailing address

669 CRESPI DR STE F
PACIFICA CA
94044
US

V. Phone/Fax

Practice location:
  • Phone: 650-359-1646
  • Fax: 831-597-5155
Mailing address:
  • Phone: 650-359-1646
  • Fax: 831-597-5155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number53802
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: