Provider Demographics
NPI:1740422021
Name:ELKE CHEUNG D.M.D. , P.C.
Entity Type:Organization
Organization Name:ELKE CHEUNG D.M.D. , P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELKE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:203-846-0400
Mailing Address - Street 1:132 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-5833
Mailing Address - Country:US
Mailing Address - Phone:917-903-6148
Mailing Address - Fax:
Practice Address - Street 1:43 NORTH AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-3816
Practice Address - Country:US
Practice Address - Phone:203-846-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0088721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty