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General NPI Number Information
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NPI Number | 1891304762
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Entity Type | Individual
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Provider Name | KRISTINE CHEUK DDS
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Gender | Female
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Dates
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Enumeration Date | 07/27/2020
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 6040 MAIN ST STE 148
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City | AMERICAN CANYON
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State | CA
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Zip | 94503-1391
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Country | US
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Telephone | 707-552-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 564 N CIVIC DR APT C
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City | WALNUT CREEK
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State | CA
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Zip | 94597-3222
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Country | US
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Telephone | 415-952-0077
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 106674
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License Number State | CA
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