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NPI Code Detail

MEDICARE: TRISHA JEN DDS

MEDICARE: TRISHA JEN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist49115CA

General Provider Information

NPI Number : 1154502656
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRISHA JEN DDS
Provider Business Mailing Address
First Line : 270 REDWOOD SHORES PKWY # 701
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94065-1173
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11501 DUBLIN BLVD STE 200
Second Line :
City : DUBLIN
State : CA
Zip : 94568-2827
Country : US
Telephone Number : 650-400-4745
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2007
Last Update Date : 11/26/2007

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Directions to “ TRISHA JEN DDS” Practice Location

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