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General NPI Number Information
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NPI Number | 1386936656
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Entity Type | Organization
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Legal Business Name | JENNIFER CHEN, D.D.S., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/05/2011
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Last Update Date | 05/05/2011
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Provider Practice Location Address
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Address Line | 8540 S. SEPULVEDA BLVD SUITE 705
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City | LOS ANGELES
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State | CA
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Zip | 90045
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Country | US
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Telephone | 310-645-5705
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Fax | 310-645-0407
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Provider Business Mailing Address
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Address Line | 2500 BRIGDEN RD
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City | PASADENA
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State | CA
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Zip | 91104-3429
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Country | US
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Telephone | 626-261-1168
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JENNIFER NIEN-HUI CHEN
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Credential | D.D.S
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Telephone | 626-261-1168
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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 | 49857
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License Number State | CA
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