Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 21849 | TX |
NPI | 1053574145 |
---|---|
Provider Name | Dr. Jianing He |
First Address | Dallas, TX 75205-5104 |
Second Address | Dallas, TX 75205-5104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2008 |
Last Update Date | 08/07/2008 |