Provider Demographics
NPI:1437477205
Name:ZHAI, RUO HONG (DDS)
Entity Type:Individual
Prefix:
First Name:RUO HONG
Middle Name:
Last Name:ZHAI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WOOLSLEY AVENUE
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4458
Mailing Address - Country:US
Mailing Address - Phone:917-331-7079
Mailing Address - Fax:203-880-4098
Practice Address - Street 1:2 CORPORATE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-1376
Practice Address - Country:US
Practice Address - Phone:203-261-2511
Practice Address - Fax:203-445-0023
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-04
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010217122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist