Provider Demographics
NPI:1841322476
Name:DANG, DARRELL ALOYSIUS (DDS)
Entity type:Individual
Prefix:
First Name:DARRELL
Middle Name:ALOYSIUS
Last Name:DANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MIDDLEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2123
Mailing Address - Country:US
Mailing Address - Phone:650-328-6356
Mailing Address - Fax:650-328-8755
Practice Address - Street 1:500 MIDDLEFIELD RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2123
Practice Address - Country:US
Practice Address - Phone:650-328-6356
Practice Address - Fax:650-328-8755
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA330291223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA91096OtherUNITED CONCORDIA ID #