Provider Demographics
NPI:1205242302
Name:CHIANG, DANNY (DMD)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:
Last Name:CHIANG
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 1:3820 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98418-7825
Mailing Address - Country:US
Mailing Address - Phone:253-472-3006
Mailing Address - Fax:253-472-3016
Practice Address - Street 1:3820 PACIFIC AVE STE 101
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98418-7825
Practice Address - Country:US
Practice Address - Phone:253-472-3006
Practice Address - Fax:253-472-3016
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-09
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60880886122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty