Provider Demographics
NPI:1821176298
Name:WANG, ZIRONG (DDS)
Entity Type:Individual
Prefix:MRS
First Name:ZIRONG
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5135 MOWRY AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1055
Mailing Address - Country:US
Mailing Address - Phone:510-792-8432
Mailing Address - Fax:510-795-8432
Practice Address - Street 1:5135 MOWRY AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1055
Practice Address - Country:US
Practice Address - Phone:510-792-8432
Practice Address - Fax:510-795-8432
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51002122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist