Provider Demographics
NPI:1639486541
Name:QING, HAI (DMD)
Entity Type:Individual
Prefix:
First Name:HAI
Middle Name:
Last Name:QING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1564 DERRY DR
Mailing Address - Street 2:
Mailing Address - City:DRESHER
Mailing Address - State:PA
Mailing Address - Zip Code:19025-1212
Mailing Address - Country:US
Mailing Address - Phone:585-201-2420
Mailing Address - Fax:
Practice Address - Street 1:1250 GREENWOOD AVE STE 10
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2900
Practice Address - Country:US
Practice Address - Phone:267-217-3218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0410631223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty