Provider Demographics
NPI:1609296482
Name:CHENG AND TZENG DENTAL INC
Entity Type:Organization
Organization Name:CHENG AND TZENG DENTAL INC
Other - Org Name:LOS ALAMITOS FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-598-7914
Mailing Address - Street 1:1111 W TOWN AND COUNTRY RD
Mailing Address - Street 2:SUITE 33
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4615
Mailing Address - Country:US
Mailing Address - Phone:714-285-0505
Mailing Address - Fax:714-285-0988
Practice Address - Street 1:3662 KATELLA AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3124
Practice Address - Country:US
Practice Address - Phone:562-598-7914
Practice Address - Fax:562-594-6156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA358601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty