1942369814 NPI number — DR. RESTITUTO LOUIE CHING D.D.S.

Table of content: DR. RESTITUTO LOUIE CHING D.D.S. (NPI 1942369814)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942369814 NPI number — DR. RESTITUTO LOUIE CHING D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHING
Provider First Name:
RESTITUTO
Provider Middle Name:
LOUIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHING
Provider Other First Name:
RESTITUTO
Provider Other Middle Name:
SALCEDO
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
JR.
Provider Other Credential Text:
D.D.S
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1942369814
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
322 S 13TH ST # 173
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAC CITY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50583-1910
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
712-662-4766
Provider Business Mailing Address Fax Number:
712-662-4796

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
322 S 13TH ST # 173
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAC CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50583-1910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-662-4766
Provider Business Practice Location Address Fax Number:
712-662-4796
Provider Enumeration Date:
12/07/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  08230 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 08230 . This is a "DELTA DENTAL" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0291542 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: IA0100 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1291542 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1607714 . This is a "UNITED CONCORDIA" identifier . This identifiers is of the category "OTHER".