Provider Demographics
NPI:1619416823
Name:CHENG, LANCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LANCE
Middle Name:
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 1:8303 COLBY ST
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-6937
Mailing Address - Country:US
Mailing Address - Phone:571-276-0896
Mailing Address - Fax:
Practice Address - Street 1:7521 VIRGINIA OAKS DR STE 210
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3831
Practice Address - Country:US
Practice Address - Phone:703-947-0836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-21
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014161781223P0221X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program