Provider Demographics
NPI:1649576760
Name:SHU PING RONG, DDS P.C
Entity Type:Organization
Organization Name:SHU PING RONG, DDS P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHU PING
Authorized Official - Middle Name:
Authorized Official - Last Name:RONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-816-2085
Mailing Address - Street 1:128 MOTT ST
Mailing Address - Street 2:SUITE # 507
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-5540
Mailing Address - Country:US
Mailing Address - Phone:212-226-6368
Mailing Address - Fax:212-226-6369
Practice Address - Street 1:128 MOTT ST
Practice Address - Street 2:SUITE # 507
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5540
Practice Address - Country:US
Practice Address - Phone:212-226-6368
Practice Address - Fax:212-226-6369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055002261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental