Dr. Jennifer M Chan, D.M.D.
Dentist in Bothell, WA. Individual provider (NPI-1).
NPI number1295069045
StatusActive
Last updated in NPPESDec 26, 2024
Details
- NPI
- 1295069045
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jennifer M Chan
- Credential
- D.M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 28, 2009
- Certification date
- Dec 26, 2024
- Last updated
- Dec 26, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | DE60487956 | WA | Yes |
| 1223G0001X | Dentist, General Practice | 22d102422200 | NJ |
Practice location
10414 Beardslee Blvd Ste 200Bothell, WA 98011-3205
Phone 425-424-6350
Mailing address
955 Powell Ave SwRenton, WA 98057-2908
Phone 425-277-1311 · Fax 425-277-1566
Other practice locations
Wright Patterson Afb Hospital
Wright Patterson Afb, OH 45433
Wright Patterson Afb, OH 45433
Phone 937-257-8761
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