Provider Demographics
NPI:1568748416
Name:ZHANG, YINGTAO (DDS)
Entity Type:Individual
Prefix:DR
First Name:YINGTAO
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2070 US HIGHWAY 1 STE 101
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3745
Mailing Address - Country:US
Mailing Address - Phone:407-421-8536
Mailing Address - Fax:
Practice Address - Street 1:2070 US HIGHWAY 1 STE 101
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3745
Practice Address - Country:US
Practice Address - Phone:407-421-8536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN19571122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist