Healthcare Provider Details

I. General information

NPI: 1619317666
Provider Name (Legal Business Name): ERINA HUNG DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2013
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10602 CHAPMAN AVE STE 200
GARDEN GROVE CA
92840-3147
US

IV. Provider business mailing address

24371 AVENIDA DE LOS NINOS
LAGUNA NIGUEL CA
92677-3513
US

V. Phone/Fax

Practice location:
  • Phone: 714-537-0700
  • Fax: 714-638-5991
Mailing address:
  • Phone: 949-310-4934
  • Fax: 239-775-7035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberS6-192C
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number102903
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: