Healthcare Provider Details

I. General information

NPI: 1851518443
Provider Name (Legal Business Name): BARRY CHIEN CHUN HUANG D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 03/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 MAGNOLIA AVE BLDG. C1
CORONA CA
92879-3119
US

IV. Provider business mailing address

720 MAGNOLIA AVE BLDG C1
CORONA CA
92879-3119
US

V. Phone/Fax

Practice location:
  • Phone: 951-737-1092
  • Fax: 951-817-9513
Mailing address:
  • Phone: 951-737-1092
  • Fax: 951-817-9513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number43972
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: