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General NPI Number Information
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NPI Number | 1174184493
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Entity Type | Individual
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Provider Name | JENNIFER ZHANG CHAI DMD
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Gender | Female
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Dates
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Enumeration Date | 06/26/2019
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 10025 19TH AVE SE STE 202
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City | EVERETT
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State | WA
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Zip | 98208-4275
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Country | US
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Telephone | 425-357-8747
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Fax |
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Provider Business Mailing Address
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Address Line | 1420 WILLOW BUD DR
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City | DIAMOND BAR
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State | CA
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Zip | 91789-3865
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Country | US
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Telephone | 909-569-7506
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE61575850
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License Number State | WA
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