Provider Demographics
NPI:1942723432
Name:FANG, PING KE (DDS)
Entity Type:Individual
Prefix:
First Name:PING
Middle Name:KE
Last Name:FANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:PINGKE
Other - Middle Name:
Other - Last Name:FANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3 LEDGEWOOD BLVD APT B47
Mailing Address - Street 2:
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1290
Mailing Address - Country:US
Mailing Address - Phone:781-864-5728
Mailing Address - Fax:
Practice Address - Street 1:3 LEDGEWOOD BLVD APT B47
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1290
Practice Address - Country:US
Practice Address - Phone:781-864-5728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18576971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice