Healthcare Provider Details

I. General information

NPI: 1982127718
Provider Name (Legal Business Name): MINGHE ZHANG DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2017
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PINCKNEY BLVD # 6216A
BEAUFORT SC
29902-6122
US

IV. Provider business mailing address

NAVAL MEDICAL CENTER SAN DIEGO 34800 BOB WILSON DR
SAN DIEGO CA
92134-5000
US

V. Phone/Fax

Practice location:
  • Phone: 843-228-5994
  • Fax:
Mailing address:
  • Phone: 619-532-7935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number10443082-9922
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10443082-9926
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: