Healthcare Provider Details

I. General information

NPI: 1558980375
Provider Name (Legal Business Name): JOSHUA CHENG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2020
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8616 WHITNEY AVE
ELMHURST NY
11373-3865
US

IV. Provider business mailing address

6254 97TH PL APT 6D
REGO PARK NY
11374-1348
US

V. Phone/Fax

Practice location:
  • Phone: 607-592-3046
  • Fax:
Mailing address:
  • Phone: 607-592-3046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number062108
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: