Healthcare Provider Details

I. General information

NPI: 1427255348
Provider Name (Legal Business Name): JENNY ZHU DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 08/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 CANAL ST 2ND FLOOR
NEW YORK NY
10002-5033
US

IV. Provider business mailing address

20 CONFUCIUS PLZ APT 24H
NEW YORK NY
10002-6708
US

V. Phone/Fax

Practice location:
  • Phone: 212-966-2349
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number22DI02336000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number051371-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: