Healthcare Provider Details

I. General information

NPI: 1720906753
Provider Name (Legal Business Name): ERIC ZHANG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 AVENUE U
BROOKLYN NY
11223-3551
US

IV. Provider business mailing address

38 PROVINCE DR
SOUTH SETAUKET NY
11720-4617
US

V. Phone/Fax

Practice location:
  • Phone: 718-373-6707
  • Fax:
Mailing address:
  • Phone: 631-974-8627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number065458
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: