Healthcare Provider Details

I. General information

NPI: 1518153725
Provider Name (Legal Business Name): STEVE HUNGJIE TSENG D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 N TELSHOR BLVD SUITE A
LAS CRUCES NM
88011-8243
US

IV. Provider business mailing address

530 N TELSHOR BLVD SUITE A
LAS CRUCES NM
88011-8243
US

V. Phone/Fax

Practice location:
  • Phone: 505-532-5437
  • Fax: 505-532-5861
Mailing address:
  • Phone: 505-532-5437
  • Fax: 505-532-5861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDD2944
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: