Provider Demographics
NPI:1275540205
Name:CHEUNG, ERIC (DDS)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
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 1:7172 REGIONAL ST
Mailing Address - Street 2:#358
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2324
Mailing Address - Country:US
Mailing Address - Phone:415-215-6108
Mailing Address - Fax:
Practice Address - Street 1:7172 REGIONAL ST
Practice Address - Street 2:#358
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2324
Practice Address - Country:US
Practice Address - Phone:415-215-6108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA539811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA53981OtherSTATE LICENSE NUMBER