Provider Demographics
NPI:1942610407
Name:CHING, KATIE (DDS)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:CHING
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 1:3342 86TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-1536
Mailing Address - Country:US
Mailing Address - Phone:347-602-0509
Mailing Address - Fax:347-602-0509
Practice Address - Street 1:13630 SANFORD AVE STE LB
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3137
Practice Address - Country:US
Practice Address - Phone:718-460-7868
Practice Address - Fax:718-460-7867
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2015-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0580741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice