Provider Demographics
NPI:1740404110
Name:DANG, CHERI AMANDA (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHERI
Middle Name:AMANDA
Last Name:DANG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 DEERWOOD RD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4409
Mailing Address - Country:US
Mailing Address - Phone:818-800-4868
Mailing Address - Fax:
Practice Address - Street 1:111 DEERWOOD RD
Practice Address - Street 2:SUITE 170
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4409
Practice Address - Country:US
Practice Address - Phone:818-800-4868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14951223D0004X
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Yes1223D0004XDental ProvidersDentistDentist Anesthesiologist