Provider Demographics
NPI:1326170457
Name:WHANG, CALVIN I (DDS)
Entity Type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:I
Last Name:WHANG
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 1:12705 MONTE VISTA RD
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2529
Mailing Address - Country:US
Mailing Address - Phone:858-487-8090
Mailing Address - Fax:858-487-8214
Practice Address - Street 1:12705 MONTE VISTA RD
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2529
Practice Address - Country:US
Practice Address - Phone:858-487-8090
Practice Address - Fax:858-487-8214
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA420191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice