Healthcare Provider Details

I. General information

NPI: 1710839931
Provider Name (Legal Business Name): YUJIE HUANG DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 TULLY RD STE 602
MODESTO CA
95356-8982
US

IV. Provider business mailing address

4101 TULLY RD STE 602
MODESTO CA
95356-8982
US

V. Phone/Fax

Practice location:
  • Phone: 628-588-6698
  • Fax: 209-529-0058
Mailing address:
  • Phone: 628-588-6698
  • Fax: 209-529-0058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: YUJIE HUANG
Title or Position: CEO/OWNER
Credential: DDS, PHD
Phone: 628-588-6698