MEDICARE: DR. VINCENT C CHENG DDS MSC APC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	41068	CA

General Provider Information

NPI Number	:	1346461977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINCENT C CHENG DDS MSC APC

Provider Business Mailing Address
First Line	:	616 NORTH MONTEBELLO BLVD.,
Second Line	:
City	:	MONTEBELLO
State	:	CO
Zip	:	90640-3538
Country	:	US
Telephone Number	:	323-728-3714
Fax Number	:	323-888-6002

Provider Business Practice Location Address
First Line	:	616 NORTH MONTEBELLO BLVD.,
Second Line	:
City	:	MONTEBELLO
State	:	CO
Zip	:	90640-3538
Country	:	US
Telephone Number	:	323-728-3714
Fax Number	:	323-888-6002

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	01/19/2021

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