Healthcare Provider Details

I. General information

NPI: 1073780482
Provider Name (Legal Business Name): ZHUANG WEN, DDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 W 17TH ST
SANTA ANA CA
92706-3622
US

IV. Provider business mailing address

15 WYOMING
IRVINE CA
92606-1768
US

V. Phone/Fax

Practice location:
  • Phone: 714-834-9888
  • Fax: 714-834-9889
Mailing address:
  • Phone: 714-834-9888
  • Fax: 714-834-9889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. ZHUANG WEN
Title or Position: PRESIDENT
Credential: DDS
Phone: 714-834-9888