Provider Demographics
NPI:1053751842
Name:CHIAO-TZE HWANG DDS INC
Entity type:Organization
Organization Name:CHIAO-TZE HWANG DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMENGOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-836-8999
Mailing Address - Street 1:4700 PANAMA LN SUITE 102
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313
Mailing Address - Country:US
Mailing Address - Phone:661-836-8999
Mailing Address - Fax:661-832-5285
Practice Address - Street 1:4700 PANAMA LN UNIT 102
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-3481
Practice Address - Country:US
Practice Address - Phone:661-836-8999
Practice Address - Fax:661-832-5285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48918122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9381701OtherMEDI-CAL