MEDICARE: VIVIAN HUYNH DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	28072	FL
2	122300000X	Dentist	2023024877	MO

General Provider Information

NPI Number	:	1508542762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIVIAN HUYNH DMD

Provider Business Mailing Address
First Line	:	807 E KARSCH BLVD
Second Line	:
City	:	FARMINGTON
State	:	MO
Zip	:	63640-3025
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	807 E KARSCH BLVD
Second Line	:
City	:	FARMINGTON
State	:	MO
Zip	:	63640-3025
Country	:	US
Telephone Number	:	573-756-5760
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2023
Last Update Date	:	06/23/2023

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Directions to “ VIVIAN HUYNH DMD” Practice Location

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