Provider Demographics
NPI:1073668620
Name:CHENG, JOSEPH TZU-SHUO
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:TZU-SHUO
Last Name:CHENG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8209 ROCHESTER AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-0744
Mailing Address - Country:US
Mailing Address - Phone:909-484-9555
Mailing Address - Fax:909-484-9730
Practice Address - Street 1:8209 ROCHESTER AVE
Practice Address - Street 2:#101
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0743
Practice Address - Country:US
Practice Address - Phone:909-484-9555
Practice Address - Fax:909-484-9730
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA435241223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry