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General NPI Number Information
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NPI Number | 1366034993
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Entity Type | Organization
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Legal Business Name | KEVIN CHIANG DDS DENTAL CORP
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Dates
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Enumeration Date | 02/04/2021
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 18250 ROSCOE BLVD STE 345
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City | NORTHRIDGE
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State | CA
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Zip | 91325-4283
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Country | US
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Telephone | 310-564-6231
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Fax |
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Provider Business Mailing Address
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Address Line | 2829 LA BONITA DR
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City | HACIENDA HEIGHTS
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State | CA
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Zip | 91745-5151
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KEVIN CHIANG
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Credential | DDS
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Telephone | 310-564-6231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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