Provider Demographics
NPI:1053768358
Name:WESLEY CHIANG DMD MS INC
Entity type:Organization
Organization Name:WESLEY CHIANG DMD MS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIANG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:408-621-3058
Mailing Address - Street 1:1298 KIFER RD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-5319
Mailing Address - Country:US
Mailing Address - Phone:408-368-6683
Mailing Address - Fax:408-351-8300
Practice Address - Street 1:1298 KIFER RD
Practice Address - Street 2:SUITE 502
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-5319
Practice Address - Country:US
Practice Address - Phone:408-368-6683
Practice Address - Fax:408-351-8300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57205261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental