Provider Demographics
NPI:1649436148
Name:CHEUNG, JOANNA (DDS)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 MORAGA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MORAGA
Mailing Address - State:CA
Mailing Address - Zip Code:94556-2254
Mailing Address - Country:US
Mailing Address - Phone:925-247-0193
Mailing Address - Fax:
Practice Address - Street 1:533 MORAGA RD STE 100
Practice Address - Street 2:
Practice Address - City:MORAGA
Practice Address - State:CA
Practice Address - Zip Code:94556-2254
Practice Address - Country:US
Practice Address - Phone:925-247-0193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0226901223P0221X
KY86731223P0221X
CA494931223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry