Provider Demographics
NPI:1528516994
Name:TSENG, SOPHIA (DMD)
Entity type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:
Last Name:TSENG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 E ALLUVIAL AVE # 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2606
Mailing Address - Country:US
Mailing Address - Phone:559-229-6557
Mailing Address - Fax:559-229-7183
Practice Address - Street 1:1406 E ALLUVIAL AVE # 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2606
Practice Address - Country:US
Practice Address - Phone:559-229-6557
Practice Address - Fax:559-229-7183
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA456281223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics