Active NPI
Edward Cheng, DDS
- General Practice Dentistry
- Racine, WI
National Provider Identifier
1306007703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6276-15
- Practice address
- 5802 Washington Ave
Ste 202
Racine, WI 53406-4050 - Phone
- (262) 886-1957
- NPI assigned
- Jun 19, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019027647 | IL | |
| General Practice Dentistry | 1223G0001X | 6276-15 | WI | Primary |
Addresses
Primary practice location
5802 Washington Ave
Ste 202
Racine, WI 53406-4050
Mailing address
5802 Washington Ave
Ste 202
Racine, WI 53406-4050
Phone (262) 886-1957
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019027647 | IL | MD | Dentist |
| 6276-15 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214870400000",
"number": "1306007703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5802 WASHINGTON AVE",
"address_2": "STE 202",
"city": "RACINE",
"state": "WI",
"postal_code": "534064050",
"telephone_number": "262-886-1957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5802 WASHINGTON AVE",
"address_2": "STE 202",
"city": "RACINE",
"state": "WI",
"postal_code": "534064050",
"telephone_number": "262-886-1957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHENG",
"first_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-19",
"last_updated": "2008-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019027647",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "6276-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Racine, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.