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General NPI Number Information
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NPI Number | 1417187634
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Entity Type | Individual
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Provider Name | JOHN J CHENG DMD
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Gender | Male
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Dates
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Enumeration Date | 07/22/2009
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 9600 SW 204TH ST
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City | VASHON
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State | WA
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Zip | 98070-6135
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Country | US
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Telephone | 206-548-7550
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 12TH AVE S STE 901
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City | SEATTLE
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State | WA
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Zip | 98144-2712
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Country | US
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Telephone | 206-548-3114
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DE60056985
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License Number State | WA
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