Provider Demographics
NPI:1942369814
Name:CHING, RESTITUTO LOUIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:RESTITUTO
Middle Name:LOUIE
Last Name:CHING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:RESTITUTO
Other - Middle Name:SALCEDO
Other - Last Name:CHING
Other - Suffix:JR
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:322 S 13TH ST # 173
Mailing Address - Street 2:
Mailing Address - City:SAC CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50583-1910
Mailing Address - Country:US
Mailing Address - Phone:712-662-4766
Mailing Address - Fax:712-662-4796
Practice Address - Street 1:322 S 13TH ST # 173
Practice Address - Street 2:
Practice Address - City:SAC CITY
Practice Address - State:IA
Practice Address - Zip Code:50583-1910
Practice Address - Country:US
Practice Address - Phone:712-662-4766
Practice Address - Fax:712-662-4796
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA082301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA08230OtherDELTA DENTAL
IA0291542Medicaid
IA0100OtherUNITED HEALTH CARE
IA1291542Medicaid
1607714OtherUNITED CONCORDIA