Provider Demographics
NPI:1730302472
Name:TANG, TED HSIANG (DDS)
Entity Type:Individual
Prefix:DR
First Name:TED
Middle Name:HSIANG
Last Name:TANG
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 1:911 S LINDSAY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-2966
Mailing Address - Country:US
Mailing Address - Phone:480-633-5653
Mailing Address - Fax:480-633-5544
Practice Address - Street 1:911 S LINDSAY RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-2966
Practice Address - Country:US
Practice Address - Phone:480-633-5653
Practice Address - Fax:480-633-5544
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5283122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist