Provider Demographics
NPI:1679095681
Name:CHUANG, PEGGY PEI JU (DMD)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:PEI JU
Last Name:CHUANG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:PEI JU
Other - Middle Name:
Other - Last Name:CHUANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:867 E STANLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-4008
Mailing Address - Country:US
Mailing Address - Phone:925-243-6491
Mailing Address - Fax:
Practice Address - Street 1:867 E STANLEY BLVD
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4008
Practice Address - Country:US
Practice Address - Phone:925-243-6491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1015191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice