MEDICARE: DR. CHIA TAW HUANG D.D.S.

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	1223G0001X	General Practice Dentistry	034892	NY
2	1223P0221X	Pediatric Dentistry	034892	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851409361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHIA TAW HUANG D.D.S.

Provider Business Mailing Address
First Line	:	625 ELMWOOD AVE
Second Line	:	BOX 683
City	:	ROCHESTER
State	:	NY
Zip	:	14620-2913
Country	:	US
Telephone Number	:	585-275-5007
Fax Number	:	585-276-0293

Provider Business Practice Location Address
First Line	:	625 ELMWOOD AVE
Second Line	:	BOX 683
City	:	ROCHESTER
State	:	NY
Zip	:	14620-2913
Country	:	US
Telephone Number	:	585-275-5007
Fax Number	:	585-276-0293

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	06/27/2016

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