Provider Demographics
NPI:1962600635
Name:VINCENT C.CHENG DDS MSC CORP.
Entity type:Organization
Organization Name:VINCENT C.CHENG DDS MSC CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MSC FADI
Authorized Official - Phone:323-728-3714
Mailing Address - Street 1:616 N MONTEBELLO BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-3538
Mailing Address - Country:US
Mailing Address - Phone:323-888-6002
Mailing Address - Fax:
Practice Address - Street 1:616 N MONTEBELLO BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3538
Practice Address - Country:US
Practice Address - Phone:323-728-3714
Practice Address - Fax:323-888-6003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA410681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty