Provider Demographics
NPI:1518179068
Name:EAST WEST DENTAL, INC.
Entity Type:Organization
Organization Name:EAST WEST DENTAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TED
Authorized Official - Middle Name:HSIANG
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-633-5653
Mailing Address - Street 1:911 S LINDSAY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-2966
Mailing Address - Country:US
Mailing Address - Phone:480-633-5653
Mailing Address - Fax:480-633-5544
Practice Address - Street 1:911 S LINDSAY RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-2966
Practice Address - Country:US
Practice Address - Phone:480-633-5653
Practice Address - Fax:480-633-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ52831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty