Provider Demographics
NPI:1376860700
Name:CHENG, JOIE
Entity Type:Individual
Prefix:DR
First Name:JOIE
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:774 ELMGROVE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-1318
Mailing Address - Country:US
Mailing Address - Phone:585-426-0810
Mailing Address - Fax:585-426-4799
Practice Address - Street 1:774 ELMGROVE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-1318
Practice Address - Country:US
Practice Address - Phone:585-426-0810
Practice Address - Fax:585-426-4799
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-25
Last Update Date:2011-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY0556661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program