Provider Demographics
NPI:1558742874
Name:CHING, CHUN-TING (DMD)
Entity Type:Individual
Prefix:
First Name:CHUN-TING
Middle Name:
Last Name:CHING
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 W KIEST BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75224-3231
Mailing Address - Country:US
Mailing Address - Phone:469-726-4441
Mailing Address - Fax:702-366-1483
Practice Address - Street 1:1150 W KIEST BLVD STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-3231
Practice Address - Country:US
Practice Address - Phone:469-726-4441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV32252122300000X, 1223G0001X
TX322521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1558742874Medicaid