Provider Demographics
NPI:1306025234
Name:STEPHEN M. DANG
Entity Type:Organization
Organization Name:STEPHEN M. DANG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DANG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:626-281-1536
Mailing Address - Street 1:1315 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-4163
Mailing Address - Country:US
Mailing Address - Phone:626-281-1536
Mailing Address - Fax:626-281-1607
Practice Address - Street 1:1315 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-4163
Practice Address - Country:US
Practice Address - Phone:626-281-1536
Practice Address - Fax:626-281-1607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-27
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA320561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1265450522OtherNPI SOLE PRACTIONER
CA$$$$$$$$$OtherSOCIAL SECURITY