Provider Demographics
NPI:1104021542
Name:BINGZHONG FANG D.M.D., INC.
Entity Type:Organization
Organization Name:BINGZHONG FANG D.M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:BINGZHONG
Authorized Official - Middle Name:
Authorized Official - Last Name:FANG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:626-254-9066
Mailing Address - Street 1:25 N SANTA ANITA AVE
Mailing Address - Street 2:SUITE K
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3111
Mailing Address - Country:US
Mailing Address - Phone:626-254-9066
Mailing Address - Fax:626-254-9069
Practice Address - Street 1:25 N SANTA ANITA AVE
Practice Address - Street 2:SUITE K
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3111
Practice Address - Country:US
Practice Address - Phone:626-254-9066
Practice Address - Fax:626-254-9069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA467911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty