Healthcare Provider Details

I. General information

NPI: 1467520718
Provider Name (Legal Business Name): JEFFREY CHIUNG NENG HUANG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10017 VALLEY VIEW STREET
CYPRESS CA
90630-4601
US

IV. Provider business mailing address

10017 VALLEY VIEW STREET
CYPRESS CA
90630-4601
US

V. Phone/Fax

Practice location:
  • Phone: 714-761-2211
  • Fax: 714-761-1064
Mailing address:
  • Phone: 714-761-2211
  • Fax: 714-761-1064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number46828
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: