Provider Demographics
NPI:1295936631
Name:QIAO, BINGSHENG
Entity type:Individual
Prefix:DR
First Name:BINGSHENG
Middle Name:
Last Name:QIAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 LOUISA TER
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-7441
Mailing Address - Country:US
Mailing Address - Phone:805-938-9902
Mailing Address - Fax:805-938-9902
Practice Address - Street 1:4723 W MAIN ST
Practice Address - Street 2:C
Practice Address - City:GUADALUPE
Practice Address - State:CA
Practice Address - Zip Code:93434-1787
Practice Address - Country:US
Practice Address - Phone:805-343-9500
Practice Address - Fax:805-343-9505
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA524541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice