Healthcare Provider Details

I. General information

NPI: 1174682280
Provider Name (Legal Business Name): HUANG AND WU DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 07/24/2020
Certification Date: 07/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 W 8TH ST SUITE E
LOS ANGELES CA
90057-4900
US

IV. Provider business mailing address

1901 W 8TH ST SUITE E
LOS ANGELES CA
90057-4900
US

V. Phone/Fax

Practice location:
  • Phone: 213-483-8180
  • Fax:
Mailing address:
  • Phone: 213-483-8180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number45541
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number41018
License Number StateCA

VIII. Authorized Official

Name: DR. SHIH-YUAN L. HUANG
Title or Position: CO-OWNER,CEO
Credential: DDS
Phone: 213-483-8180