Healthcare Provider Details
I. General information
NPI: 1275358152
Provider Name (Legal Business Name): SHOU CHIA HUANG DMD INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/18/2024
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
888 S FIGUEROA ST STE 750
LOS ANGELES CA
90017-2776
US
IV. Provider business mailing address
888 S FIGUEROA ST STE 750
LOS ANGELES CA
90017-2776
US
V. Phone/Fax
- Phone: 213-340-3355
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223D0001X |
| Taxonomy | Public Health Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHOU CHIA
HUANG
Title or Position: DENTIST
Credential: DMD
Phone: 949-302-6750