Provider Demographics
NPI:1699988063
Name:CHEUNG, LUISA KIT (DDS)
Entity type:Individual
Prefix:DR
First Name:LUISA
Middle Name:KIT
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 EL CAMINO REAL
Mailing Address - Street 2:SUITE #207
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-2059
Mailing Address - Country:US
Mailing Address - Phone:650-583-4266
Mailing Address - Fax:650-583-4267
Practice Address - Street 1:660 EL CAMINO REAL
Practice Address - Street 2:SUITE #207
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-2059
Practice Address - Country:US
Practice Address - Phone:650-583-4266
Practice Address - Fax:650-583-4267
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA465721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice