Provider Demographics
NPI:1356672042
Name:PING KANG CHENG DMD MSCD INC
Entity Type:Organization
Organization Name:PING KANG CHENG DMD MSCD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PING KANG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:808-596-2285
Mailing Address - Street 1:1314 S KING ST STE 725
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1942
Mailing Address - Country:US
Mailing Address - Phone:808-596-2285
Mailing Address - Fax:808-591-0068
Practice Address - Street 1:1314 S KING ST STE 725
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1942
Practice Address - Country:US
Practice Address - Phone:808-596-2285
Practice Address - Fax:808-591-0068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-12981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI014915-01Medicaid