Provider Demographics
NPI:1437519386
Name:SHEEN, QIAN ZHUANG (DDS)
Entity Type:Individual
Prefix:
First Name:QIAN
Middle Name:ZHUANG
Last Name:SHEEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:QIAN
Other - Middle Name:
Other - Last Name:ZHUANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3427 DEER PARK DR STE C
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-2355
Mailing Address - Country:US
Mailing Address - Phone:209-478-3036
Mailing Address - Fax:
Practice Address - Street 1:3427 DEER PARK DR STE C
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-2355
Practice Address - Country:US
Practice Address - Phone:209-478-3036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-03
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1019531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD9469666OtherDRIVER LICENSE