Jishen NA, D.D.S. Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

45933 Issued in CA

Legal business name

JISHEN NA, D.D.S. INC

Practice address

40928 Fremont Blvd
Fremont, CA 94538-4375

Phone

(510) 656-9998

NPI assigned

May 8, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jishen NANPI 1710108717

Title

Chairman

Phone

(510) 656-9998

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jishen NA, D.D.S

  • General Practice Dentistry
  • Fremont, CA
  • NPI 1710108717
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023221595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40928 FREMONT BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945384375",
            "telephone_number": "510-656-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40928 FREMONT BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945384375",
            "telephone_number": "510-656-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JISHEN NA, D.D.S. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NA",
        "authorized_official_first_name": "JISHEN",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "510-656-9998",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710108717",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roderico Jimenez, P.T.
• Kai Jing, M.D.
• Kamlesh R. Jinjuwadia, D.D.S
• Joy Jinkerson
• Jinwoo Jeong Dental Corporation
• JJW Pacific Health Group LLC (Moodup Wellness)
• Jan Julius Jocson, RN
• Brenda C Joe-Matsuo, M.S., MFT
• Isabella Joe
• Vy Joel, DC

• General Practice Dentistry in Fremont, CA
• Providers in Fremont, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.