Craig Daniel Cheng, D.D.S.
Individual provider Active NPI Dentist · Altadena, CA
NPI 1376839753 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1376839753
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 60441 (CA)
- Practice address
- 2028 Lake Ave
Altadena, CA 91001-2450 - Phone
- (626) 797-7551
- NPI assigned
- Jun 23, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60441 | CA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 60441 | CA | |
| Dentist | 122300000X | 60441 | CA | Yes |
Addresses
Primary practice location
2028 Lake Ave
Altadena, CA 91001-2450
Mailing address
2028 Lake Ave
Altadena, CA 91001-2450
Phone (626) 797-7551
Other practice location 1
19810 E Skyline Dr
Walnut, CA 91789-5301
Phone (909) 851-2423
Other providers in Altadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.