Provider Demographics
NPI:1497572408
Name:BATAC, CINDY CHUNG (DDS)
Entity type:Individual
Prefix:DR
First Name:CINDY
Middle Name:CHUNG
Last Name:BATAC
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 S MCCARTY DR APT 18
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4095
Mailing Address - Country:US
Mailing Address - Phone:626-202-8026
Mailing Address - Fax:
Practice Address - Street 1:14101 NELSON AVE
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91746-2640
Practice Address - Country:US
Practice Address - Phone:626-688-6407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-21
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110545122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist