Healthcare Provider Details

I. General information

NPI: 1861831414
Provider Name (Legal Business Name): TAMMY HUANG DMD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 07/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16520 BAKE PKWY SUITE #135
IRVINE CA
92618-4668
US

IV. Provider business mailing address

8 COMISO
IRVINE CA
92614-0224
US

V. Phone/Fax

Practice location:
  • Phone: 559-788-2532
  • Fax:
Mailing address:
  • Phone: 949-903-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number62450
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: