Provider Demographics
NPI:1295936607
Name:QUYNHCHI N VAN LANG DMD
Entity type:Organization
Organization Name:QUYNHCHI N VAN LANG DMD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DDS VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIOT
Authorized Official - Middle Name:S
Authorized Official - Last Name:ESSENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:203-655-8887
Mailing Address - Street 1:53 OLD KINGS HIGHWAY NORTH
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820
Mailing Address - Country:US
Mailing Address - Phone:203-655-8887
Mailing Address - Fax:203-655-0524
Practice Address - Street 1:53 OLD KINGS HIGHWAY NORTH
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820
Practice Address - Country:US
Practice Address - Phone:203-655-8887
Practice Address - Fax:203-655-0524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty