Provider Demographics
NPI:1831810563
Name:ZHANG, JIAYANG (DMD)
Entity type:Individual
Prefix:DR
First Name:JIAYANG
Middle Name:
Last Name:ZHANG
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 1:415 KEATING ST APT 4407
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-5093
Mailing Address - Country:US
Mailing Address - Phone:502-608-7302
Mailing Address - Fax:
Practice Address - Street 1:1144 CARTHAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4161
Practice Address - Country:US
Practice Address - Phone:919-774-1733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12946122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist