1386181287 NPI number — GIAC DANG DMD INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386181287 NPI number — GIAC DANG DMD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GIAC DANG DMD INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386181287
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/30/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 MEETING HOUSE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHELMSFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01824-2738
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-256-7322
Provider Business Mailing Address Fax Number:
978-256-6932

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 MEETING HOUSE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHELMSFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01824-2738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-256-7322
Provider Business Practice Location Address Fax Number:
978-256-6932
Provider Enumeration Date:
01/30/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DANG
Authorized Official First Name:
GIAC
Authorized Official Middle Name:
H
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
978-256-7322

Provider Taxonomy Codes

  • Taxonomy code: 1223P0300X , with the licence number:  DN1855796 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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