Healthcare Provider Details

I. General information

NPI: 1306604822
Provider Name (Legal Business Name): ZHENGDONG TANG L.AC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3921 SUNSET RIDGE RD STE 302
RALEIGH NC
27607-6681
US

IV. Provider business mailing address

2500 SIDEWINDER CT
APEX NC
27523-8503
US

V. Phone/Fax

Practice location:
  • Phone: 919-503-3558
  • Fax: 919-823-6060
Mailing address:
  • Phone: 919-503-3558
  • Fax: 919-823-6060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: