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Contact Information

FUCONG TIAN, BDS, PHD
12040 W BROAD STREET
HENRICO, VA23233
 Phone: 804-364-7010
 Fax: 706-721-6778
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for FUCONG TIAN · (Male)

NPI Number 1992295646
Status Active
Credentials BDS, PHD
Entity Individual
Enumeration date 05/17/2018
Last updated 07/09/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • GA License # DNF000434
  • TX License # 37946
  • VA License # 0401418375
  • WA License # DE61171559
  • GA Medicaid 003241248A
  • SC Medicaid ZX0434
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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