Provider Demographics
NPI:1669503488
Name:ZHANG, HAI
Entity Type:Individual
Prefix:DR
First Name:HAI
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2387 S 102ND ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-2146
Mailing Address - Country:US
Mailing Address - Phone:414-329-1171
Mailing Address - Fax:414-329-1018
Practice Address - Street 1:2387 S 102ND ST
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-2146
Practice Address - Country:US
Practice Address - Phone:414-329-1171
Practice Address - Fax:414-329-1018
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5482-015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33781600Medicaid
WI33781600Medicaid