Individual
DR. CHIEN YUAN CHENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MD
Contact information
Practice address
1663 DOMINICAN WAY, SUITE 112, SANTA CRUZ, CA 95065
(831) 475-0221
(831) 475-3573
Mailing address
1663 DOMINICAN WAY, SUITE 112, SANTA CRUZ, CA 95065
(831) 475-0221
(831) 475-3573
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
245438
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1298
ANESTHESIA LICENSE
CA
01
—
45438
DENTAL LICENSE
CA
01
—
A88948
MEDICAL LICENSE
CA
Enumeration date
08/19/2006
Last updated
03/07/2023
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