Provider Demographics
NPI:1558491282
Name:CHENG, KEVIN KUO TSAI (DDS)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:KUO TSAI
Last Name:CHENG
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 1:6000 S MCCLINTOCK DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283
Mailing Address - Country:US
Mailing Address - Phone:480-820-6131
Mailing Address - Fax:480-820-6131
Practice Address - Street 1:6000 S MCCLINTOCK DR
Practice Address - Street 2:SUITE B
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283
Practice Address - Country:US
Practice Address - Phone:480-820-6131
Practice Address - Fax:480-820-6131
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2942122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist