Provider Demographics
NPI:1326145509
Name:CHEUNG PROFESSIONAL DENTAL CORP.
Entity Type:Organization
Organization Name:CHEUNG PROFESSIONAL DENTAL CORP.
Other - Org Name:CHEUNG DENTAL GROUP CHINATOWN, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-399-8888
Mailing Address - Street 1:1283 22ND AVE. 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-1601
Mailing Address - Country:US
Mailing Address - Phone:415-753-9888
Mailing Address - Fax:415-753-9688
Practice Address - Street 1:1283 22ND AVE. 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-1601
Practice Address - Country:US
Practice Address - Phone:415-753-9888
Practice Address - Fax:415-753-9688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA337341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty