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General NPI Number Information
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NPI Number | 1689939167
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Entity Type | Organization
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Legal Business Name | JASON S. CHING D.D.S., INC.
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Dates
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Enumeration Date | 07/10/2012
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Last Update Date | 07/30/2012
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Provider Practice Location Address
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Address Line | 15218 SUMMIT AVE SUITE 150
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City | FONTANA
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State | CA
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Zip | 92336-0232
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Country | US
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Telephone | 909-333-6875
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Fax | 951-308-2637
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Provider Business Mailing Address
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Address Line | 15218 SUMMIT AVE SUITE 150
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City | FONTANA
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State | CA
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Zip | 92336-0232
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Country | US
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Telephone | 909-333-6875
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Fax | 951-308-2637
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JASON CHING
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Credential |
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Telephone | 909-333-6875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 53202
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License Number State | CA
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