Healthcare Provider Details

I. General information

NPI: 1801596101
Provider Name (Legal Business Name): EDWARD DING
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 SKILLMAN AVE
BROOKLYN NY
11211-1638
US

IV. Provider business mailing address

247 E 28TH ST APT 12E
NEW YORK NY
10016-8511
US

V. Phone/Fax

Practice location:
  • Phone: 718-866-3806
  • Fax:
Mailing address:
  • Phone: 408-621-8349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number065770
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: