Provider Demographics
NPI:1003104589
Name:CHENG, HUANG KEVIN (DDS)
Entity type:Individual
Prefix:
First Name:HUANG
Middle Name:KEVIN
Last Name:CHENG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5866 MOWRY SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-5367
Mailing Address - Country:US
Mailing Address - Phone:408-438-8893
Mailing Address - Fax:510-656-4494
Practice Address - Street 1:5866 MOWRY SCHOOL RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-5367
Practice Address - Country:US
Practice Address - Phone:510-656-4400
Practice Address - Fax:510-656-4494
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60523122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist