Healthcare Provider Details

I. General information

NPI: 1710918263
Provider Name (Legal Business Name): DR. JENNY J. CHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JI-YU CHEN DDS

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 SUTTER ST RM 1438
SAN FRANCISCO CA
94108-4010
US

IV. Provider business mailing address

450 SUTTER STREET, SUITE1438
SAN FRANCISCO CA
94108
US

V. Phone/Fax

Practice location:
  • Phone: 415-986-9868
  • Fax:
Mailing address:
  • Phone: 415-986-9868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number37987
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: