Provider Demographics
NPI:1265422893
Name:CHIANG, NANLIN (DMD MD)
Entity type:Individual
Prefix:DR
First Name:NANLIN
Middle Name:
Last Name:CHIANG
Suffix:
Gender:M
Credentials:DMD MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2398 FAIR OAKS BLVD
Mailing Address - Street 2:SUITE #1A
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825
Mailing Address - Country:US
Mailing Address - Phone:916-283-8818
Mailing Address - Fax:916-283-8815
Practice Address - Street 1:2398 FAIR OAKS BLVD
Practice Address - Street 2:SUITE #1A
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825
Practice Address - Country:US
Practice Address - Phone:916-283-8818
Practice Address - Fax:916-283-8815
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA20166208600000X
CA548201223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery