Provider Demographics
NPI:1922206150
Name:PATRICK P. CHENG, DDS, INC.
Entity Type:Organization
Organization Name:PATRICK P. CHENG, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-738-5511
Mailing Address - Street 1:2208 W COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-3021
Mailing Address - Country:US
Mailing Address - Phone:714-738-5511
Mailing Address - Fax:714-738-7768
Practice Address - Street 1:2208 W COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-3021
Practice Address - Country:US
Practice Address - Phone:714-738-5511
Practice Address - Fax:714-738-7768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44851261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental