Healthcare Provider Details

I. General information

NPI: 1417390253
Provider Name (Legal Business Name): BRIAN K HUH DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2013
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1903 E FIR AVE STE 101
FRESNO CA
93720-3862
US

IV. Provider business mailing address

1903 E FIR AVE STE 101
FRESNO CA
93720-3862
US

V. Phone/Fax

Practice location:
  • Phone: 559-226-2722
  • Fax: 559-226-6989
Mailing address:
  • Phone: 559-226-2722
  • Fax: 559-226-6989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number63734
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: