Anne Marie Jeng

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

107321 Issued in CA

Practice address

750 Las Gallinas Ave Ste 201
San Rafael, CA 94903-3432

Phone

(415) 492-1616

NPI assigned

Sep 10, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Familia Dental West Green Bay

  • Dental Clinic/Center
  • Green Bay, WI
  • NPI 1588197149

  General Practice

  NPD (past)

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1043825706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 E ALGONQUIN RD STE 610",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734166",
            "telephone_number": "888-988-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 LAS GALLINAS AVE STE 201",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033432",
            "telephone_number": "415-492-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENG",
        "first_name": "ANNE MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominique Javier
• Laurie Javier
• Larry Allen Jean
• Jeff Vanderheym Sun Valley Chiropractic
• Christopher A Jefferson
• Kimberly Ann Jenkinson
• Jennea R Wood
• Cindy Jepsen
• Timothy Jergesen
• Jacqueline Tom Jew, RN

• General Practice Dentistry in San Rafael, CA
• Providers in San Rafael, 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 Apr 24, 2025; 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.