Healthcare Provider Details

I. General information

NPI: 1710745260
Provider Name (Legal Business Name): JING HE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34460 MONTEREY AVE STE 100
PALM DESERT CA
92211-6008
US

IV. Provider business mailing address

74401 HOVLEY LN E APT 1615
PALM DESERT CA
92260-1713
US

V. Phone/Fax

Practice location:
  • Phone: 442-227-5432
  • Fax:
Mailing address:
  • Phone: 713-898-7589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number113317
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: