Provider Demographics
NPI:1881117307
Name:CHING, CODY ERNEST
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:ERNEST
Last Name:CHING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 FORESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WINTERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43953-9044
Mailing Address - Country:US
Mailing Address - Phone:740-266-6524
Mailing Address - Fax:
Practice Address - Street 1:347 W SPRING ST
Practice Address - Street 2:
Practice Address - City:CADIZ
Practice Address - State:OH
Practice Address - Zip Code:43907-1045
Practice Address - Country:US
Practice Address - Phone:740-317-6655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0251981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice