Provider Demographics
NPI:1184234536
Name:GE, SHENG (DMD)
Entity type:Individual
Prefix:
First Name:SHENG
Middle Name:
Last Name:GE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 W FAYETTE ST APT 1401
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-3467
Mailing Address - Country:US
Mailing Address - Phone:646-266-8658
Mailing Address - Fax:
Practice Address - Street 1:305 W FAYETTE ST APT 1401
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-3467
Practice Address - Country:US
Practice Address - Phone:646-266-8658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD163341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty