Jieru Pan DDS a Professional Corp.

Primary specialty

DentistTaxonomy code 122300000X

License

51123 Issued in CA

Legal business name

JIERU PAN DDS A PROFESSIONAL CORP.

Practice address

1818 Sierra Leone Ave.
Suite C
Rowland Heights, CA 91748

Phone

(626) 581-9152

Fax

(626) 581-9155

NPI assigned

Nov 2, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Jieru Pan, D.D.S.

Title

Ceo

Phone

(310) 484-9154

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1902182041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 SIERRA LEONE AVE.",
            "address_2": "SUITE C",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "91748",
            "telephone_number": "626-581-9152",
            "fax_number": "626-581-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 SIERRA LEONE AVE.",
            "address_2": "SUITE C",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "91748",
            "telephone_number": "626-581-9152",
            "fax_number": "626-581-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIERU PAN DDS A PROFESSIONAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-02",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "PAN",
        "authorized_official_first_name": "JIERU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-484-9154",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "51123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Rowland Heights, CA
• Providers in Rowland Heights, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; 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.