Provider Demographics
NPI:1104980309
Name:LANGER, CAROLYN (DDS)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:LANGER
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 1:20600 LAKE CHABOT RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546
Mailing Address - Country:US
Mailing Address - Phone:510-538-5339
Mailing Address - Fax:510-538-2768
Practice Address - Street 1:20600 LAKE CHABOT RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546
Practice Address - Country:US
Practice Address - Phone:510-538-5339
Practice Address - Fax:510-538-2768
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46090122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist