Provider Demographics
NPI:1770103111
Name:LUNG, WEIJIAN CODY (DDS)
Entity type:Individual
Prefix:
First Name:WEIJIAN
Middle Name:CODY
Last Name:LUNG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:CODY
Other - Middle Name:
Other - Last Name:LUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CODY LUNG DDS
Mailing Address - Street 1:1733 WOODSIDE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061
Mailing Address - Country:US
Mailing Address - Phone:650-716-4888
Mailing Address - Fax:
Practice Address - Street 1:1733 WOODSIDE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061
Practice Address - Country:US
Practice Address - Phone:650-716-4888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-24
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1065781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice