Healthcare Provider Details

I. General information

NPI: 1023010568
Provider Name (Legal Business Name): DAVID CHENG D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 CHATHAM SQ SUITE 706
NEW YORK NY
10038-1000
US

IV. Provider business mailing address

209 NEW HYDE PARK RD
GARDEN CITY NY
11530-2323
US

V. Phone/Fax

Practice location:
  • Phone: 212-406-0942
  • Fax: 516-488-3076
Mailing address:
  • Phone: 516-488-3076
  • Fax: 516-488-3076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number041952
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: