Provider Demographics
NPI:1528232105
Name:ZHANG, LIQUN (DDS PHD)
Entity Type:Individual
Prefix:DR
First Name:LIQUN
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:DDS PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 NESCONSET HWY, BUILDING 14D
Mailing Address - Street 2:THREE VILLAGE DENTAL, P.C.
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790
Mailing Address - Country:US
Mailing Address - Phone:631-689-7740
Mailing Address - Fax:631-689-7740
Practice Address - Street 1:2500 NESCONSET HWY, BUILDING 14D
Practice Address - Street 2:THREE VILLAGE DENTAL, P.C.
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790
Practice Address - Country:US
Practice Address - Phone:631-689-7740
Practice Address - Fax:631-689-7740
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0538981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice