Provider Demographics
NPI:1891214037
Name:CHO & KANG DENTAL CORP
Entity Type:Organization
Organization Name:CHO & KANG DENTAL CORP
Other - Org Name:DENTAL SPA OF ARTESIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMBRANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-468-1168
Mailing Address - Street 1:11960 ARTESIA BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-4093
Mailing Address - Country:US
Mailing Address - Phone:562-468-1168
Mailing Address - Fax:562-468-1158
Practice Address - Street 1:11960 ARTESIA BLVD SUITE 200
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701
Practice Address - Country:US
Practice Address - Phone:562-468-1168
Practice Address - Fax:562-468-1158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1223G0001X
261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty