Provider Demographics
NPI:1407860281
Name:CHEUNG, JERRY NAI MAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:NAI MAN
Last Name:CHEUNG
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 1:7215 SAWMILL RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-5011
Mailing Address - Country:US
Mailing Address - Phone:614-799-9140
Mailing Address - Fax:614-799-9146
Practice Address - Street 1:7215 SAWMILL RD
Practice Address - Street 2:SUITE 210
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-5011
Practice Address - Country:US
Practice Address - Phone:614-799-9140
Practice Address - Fax:614-799-9146
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH211591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice