Provider Demographics
NPI:1427101609
Name:CHENG, ALLEN Y (DMD)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:Y
Last Name:CHENG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 MILLBURN AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1942
Mailing Address - Country:US
Mailing Address - Phone:973-376-8883
Mailing Address - Fax:973-376-9841
Practice Address - Street 1:120 MILLBURN AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1942
Practice Address - Country:US
Practice Address - Phone:973-376-8883
Practice Address - Fax:973-376-9841
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 011814001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice