Provider Demographics
NPI:1841446309
Name:ZHUO, EDWARD XING GUO (DDS)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:XING GUO
Last Name:ZHUO
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 1:13261 41ST RD
Mailing Address - Street 2:APT 102
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-4285
Mailing Address - Country:US
Mailing Address - Phone:718-886-0860
Mailing Address - Fax:
Practice Address - Street 1:15402 33RD AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-3314
Practice Address - Country:US
Practice Address - Phone:917-558-1666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054117122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist