Healthcare Provider Details

I. General information

NPI: 1831881739
Provider Name (Legal Business Name): ANDREW BOWEN ZHANG DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1039 PEACHTREE INDUSTRIAL BLVD STE A116
SUWANEE GA
30024-8766
US

IV. Provider business mailing address

8735 DUNWOODY PL STE R
SANDY SPRINGS GA
30350-2995
US

V. Phone/Fax

Practice location:
  • Phone: 770-614-3232
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN123921
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: