Healthcare Provider Details

I. General information

NPI: 1750206553
Provider Name (Legal Business Name): NATHEN DANG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 SQUIRE HALL UNIVERSITY AT BUFFALO SCHOOL OF DENTAL MEDICINE
BUFFALO NY
14214
US

IV. Provider business mailing address

114 SQUIRE HALL UNIVERSITY AT BUFFALO SCHOOL OF DENTAL MEDICINE
BUFFALO NY
14214
US

V. Phone/Fax

Practice location:
  • Phone: 716-829-6237
  • Fax: 716-829-3895
Mailing address:
  • Phone: 716-829-6237
  • Fax: 716-829-3895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: