Provider Demographics
NPI:1215333547
Name:ZHANG, TAORAN (DDS)
Entity type:Individual
Prefix:
First Name:TAORAN
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10631 OHIO ST APT 4
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-1826
Mailing Address - Country:US
Mailing Address - Phone:313-433-0537
Mailing Address - Fax:
Practice Address - Street 1:10631 OHIO ST APT 4
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-1826
Practice Address - Country:US
Practice Address - Phone:313-433-0537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-13
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63465122300000X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics