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General NPI Number Information
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NPI Number | 1205728607
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Entity Type | Organization
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Legal Business Name | VAN TANG DMD, INC.
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Dates
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Enumeration Date | 07/18/2025
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 891 KUHN DR STE 100
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City | CHULA VISTA
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State | CA
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Zip | 91914-3551
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Country | US
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Telephone | 619-257-1010
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Fax | 619-257-1011
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Provider Business Mailing Address
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Address Line | 891 KUHN DR STE 100
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City | CHULA VISTA
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State | CA
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Zip | 91914-3551
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Country | US
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Telephone | 619-257-1010
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Fax | 619-257-1011
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. VAN K TANG
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Credential | DMD
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Telephone | 619-257-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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