Provider Demographics
NPI:1841650645
Name:PERFECT DENTAL
Entity type:Organization
Organization Name:PERFECT DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHENG PO
Authorized Official - Middle Name:
Authorized Official - Last Name:FENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-735-6888
Mailing Address - Street 1:20735 STEVENS CREEK BLVD
Mailing Address - Street 2:#G
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-2162
Mailing Address - Country:US
Mailing Address - Phone:408-725-8300
Mailing Address - Fax:
Practice Address - Street 1:500 BOLLINGER CANYON WAY
Practice Address - Street 2:#G
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94582-5251
Practice Address - Country:US
Practice Address - Phone:925-735-6888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA502491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty