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General NPI Number Information
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NPI Number | 1982133385
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Entity Type | Individual
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Provider Name | STEPHEN CHEUNG DDS
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Gender | Male
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 1420 S MILLS AVE STE D
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City | LODI
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State | CA
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Zip | 95242-4291
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Country | US
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Telephone | 209-369-3617
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Fax | 209-369-0498
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Provider Business Mailing Address
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Address Line | 1420 S MILLS AVE STE D
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City | LODI
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State | CA
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Zip | 95242-4291
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Country | US
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Telephone | 209-369-3617
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Fax | 209-369-0498
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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 | 2901022200
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DDS101878
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License Number State | CA
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