MEDICARE: JIN JIN DENTAL INC

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
1	122300000X	Dentist

General Provider Information

NPI Number	:	1598272775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JIN JIN DENTAL INC

Provider Business Mailing Address
First Line	:	9681 GARDEN GROVE BLVD STE 104
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92844-1548
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9681 GARDEN GROVE BLVD STE 104
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92844-1548
Country	:	US
Telephone Number	:	714-539-8275
Fax Number	:

Authorized Official
Title or Position	:	ADMIN
Name	:	JANICE PARK
Credential	:
Telephone Number	:	714-337-4410

Provider Enumeration Date	:	01/09/2018
Last Update Date	:	01/09/2018

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Directions to “JIN JIN DENTAL INC ” Practice Location

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