Provider Demographics
NPI:1245792241
Name:CRAIG D. CHENG, D.D.S., INC.
Entity Type:Organization
Organization Name:CRAIG D. CHENG, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-797-7551
Mailing Address - Street 1:2028 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-2450
Mailing Address - Country:US
Mailing Address - Phone:626-797-7551
Mailing Address - Fax:626-797-0523
Practice Address - Street 1:2028 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-2450
Practice Address - Country:US
Practice Address - Phone:626-797-7551
Practice Address - Fax:626-797-0523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental