Healthcare Provider Details

I. General information

NPI: 1790569457
Provider Name (Legal Business Name): YANZHI HUANG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2023
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 HOLIDAY LN STE D
FAIRFIELD CA
94534-3426
US

IV. Provider business mailing address

1370 HOLIDAY LN STE D
FAIRFIELD CA
94534-3426
US

V. Phone/Fax

Practice location:
  • Phone: 707-759-1039
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number109659
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: