Jane Jiao, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

103672 Issued in CA

Practice address

1802 San Miguel Dr
Walnut Creek, CA 94596-8606

Phone

(925) 934-5526

NPI assigned

Aug 1, 2014

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

Other identifiers 1

Other names 1

• Dr. Jian Jiao Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

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  • NPI 1831226117
  NPD (past)

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

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1407264591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 SAN MIGUEL DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945968606",
            "telephone_number": "925-934-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 SAN MIGUEL DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945968606",
            "telephone_number": "925-934-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIAO",
        "first_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-01",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "103672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA DENTAL BOARD",
            "identifier": "103672",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIAN",
            "last_name": "JIAO",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dafne Jimenez
• Elizabeth Jimenez
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• Periodontics in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.