Provider Demographics
NPI:1003021098
Name:CHEUNG, KEVIN KAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:KAY
Last Name:CHEUNG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 WEBSTER ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4254
Mailing Address - Country:US
Mailing Address - Phone:510-763-3333
Mailing Address - Fax:
Practice Address - Street 1:714 WEBSTER ST
Practice Address - Street 2:SUITE 107
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4254
Practice Address - Country:US
Practice Address - Phone:510-763-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA309331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice