Provider Demographics
NPI:1184142002
Name:CHIANG, VICTOR (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:
Last Name:CHIANG
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 CATHEDRAL PKWY APT 5E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-4061
Mailing Address - Country:US
Mailing Address - Phone:917-442-1135
Mailing Address - Fax:
Practice Address - Street 1:77 BOWERY FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-4915
Practice Address - Country:US
Practice Address - Phone:212-274-0477
Practice Address - Fax:212-274-0499
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0594431223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics