Jieru Pan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

51123 Issued in CA

Practice address

22514 Mountain Laurel Way
Diamond Bar, CA 91765-2522

Phone

(909) 861-6310

NPI assigned

Jul 12, 2007

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1184823957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22514 MOUNTAIN LAUREL WAY",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917652522",
            "telephone_number": "909-861-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22514 MOUNTAIN LAUREL WAY",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917652522",
            "telephone_number": "909-861-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "JIERU",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Eugene Ortigo, PSYD
• Kathy Ou, PHARM.D
• Stephen Ou, MD
• Pak Dental Inc.
• Jongson Pak, DDS GENERAL DENTISTR
• Yann Ping Pan, MD
• Parvita Paresh Panchal, DO
• Lucas Ivan Paredes, D.C
• Angela Park
• Grace Park, D.C.

• General Practice Dentistry in Diamond Bar, CA
• Providers in Diamond Bar, 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 May 21, 2008; 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.