Provider Demographics
NPI:1043701204
Name:CHENG ZHU DMD PC
Entity type:Organization
Organization Name:CHENG ZHU DMD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CHENG
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:925-692-2010
Mailing Address - Street 1:1894 CONTRA COSTA BLVD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523
Mailing Address - Country:US
Mailing Address - Phone:925-692-2010
Mailing Address - Fax:
Practice Address - Street 1:1894 CONTRA COSTA BLVD
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523
Practice Address - Country:US
Practice Address - Phone:925-692-2010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61992261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental