Provider Demographics
NPI:1043404502
Name:ZHANG, RONG (DDS)
Entity Type:Individual
Prefix:
First Name:RONG
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10141 LASAINE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-1509
Mailing Address - Country:US
Mailing Address - Phone:310-985-4975
Mailing Address - Fax:
Practice Address - Street 1:10141 LASAINE AVE
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-1509
Practice Address - Country:US
Practice Address - Phone:310-985-4975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55337122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist