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General NPI Number Information
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NPI Number | 1801819065
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Entity Type | Individual
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Provider Name | ZHUANG WEN I DDS
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 711 W 17TH ST
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City | SANTA ANA
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State | CA
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Zip | 92706-3622
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Country | US
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Telephone | 714-834-9888
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Fax |
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Provider Business Mailing Address
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Address Line | 15 WYOMING
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City | IRVINE
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State | CA
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Zip | 92606-1768
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Country | US
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Telephone | 714-834-9888
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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 | 45996
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License Number State | CA
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