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General NPI Number Information
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NPI Number | 1023221595
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Entity Type | Organization
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Legal Business Name | JISHEN NA, D.D.S. INC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 40928 FREMONT BLVD
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City | FREMONT
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State | CA
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Zip | 94538-4375
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Country | US
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Telephone | 510-656-9998
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Fax |
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Provider Business Mailing Address
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Address Line | 40928 FREMONT BLVD
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City | FREMONT
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State | CA
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Zip | 94538-4375
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Country | US
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Telephone | 510-656-9998
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN
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Name | DR. JISHEN NA
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Credential |
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Telephone | 510-656-9998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 45933
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License Number State | CA
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