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General NPI Number Information
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NPI Number | 1255957882
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Entity Type | Individual
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Provider Name | EDWIN TSANG DMD, MSD
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Gender | Male
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Dates
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Enumeration Date | 06/19/2020
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 999 E STANLEY BLVD STE C
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City | LIVERMORE
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State | CA
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Zip | 94550-4050
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Country | US
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Telephone | 925-258-8450
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Fax |
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Provider Business Mailing Address
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Address Line | 2407 ROOKE AVE
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City | HONOLULU
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State | HI
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Zip | 96817-1346
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Country | US
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Telephone | 808-382-3883
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 36192
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DDS106879
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License Number State | CA
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