Healthcare Provider Details

I. General information

NPI: 1205762507
Provider Name (Legal Business Name): ZHENG ZHANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 E FOOTHILL BLVD STE 206
ARCADIA CA
91006-2361
US

IV. Provider business mailing address

2500 WILSHIRE BLVD APT 921
LOS ANGELES CA
90057-5427
US

V. Phone/Fax

Practice location:
  • Phone: 626-604-2785
  • Fax:
Mailing address:
  • Phone: 205-427-7853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number113195
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: