Provider Demographics
NPI:1497886691
Name:TANG, WAYMAN (DDS)
Entity Type:Individual
Prefix:
First Name:WAYMAN
Middle Name:
Last Name:TANG
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:PO BOX 20961
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-8961
Mailing Address - Country:US
Mailing Address - Phone:510-888-9298
Mailing Address - Fax:510-888-1170
Practice Address - Street 1:4027 E CASTRO VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94552-4820
Practice Address - Country:US
Practice Address - Phone:510-415-1661
Practice Address - Fax:510-888-1170
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41555122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist