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Contact Information

JUSTIN FANG
999 E STANLEY BLVD STE C
LIVERMORE, CA94550-4050
 Phone: 925-258-8450
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
 

Dentist

122300000X
 

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for JUSTIN FANG · (Male)

NPI # 1538793526
Status Active
Credentials
Entity Individual
Enumeration date 02/27/2020
Last updated 09/08/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 108877
  • TX License # 37055
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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