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General NPI Number Information
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NPI Number | 1881038362
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Entity Type | Individual
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Provider Name | SHENG JI
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Gender | Male
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 07/04/2019
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Provider Practice Location Address
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Address Line | 6600 MADISON AVE STE 10
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City | CARMICHAEL
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State | CA
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Zip | 95608-0645
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Country | US
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Telephone | 916-961-1902
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Fax |
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Provider Business Mailing Address
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Address Line | 6600 MADISON AVE STE 10
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City | CARMICHAEL
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State | CA
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Zip | 95608-0645
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Country | US
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Telephone |
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 102727
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License Number State | CA
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