Healthcare Provider Details

I. General information

NPI: 1043359904
Provider Name (Legal Business Name): MINDY MIN ZHONG HUANG GAO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MIN ZHONG HUANG DDS

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 SHOWERS DRIVE SUITE #3
MOUNTAIN VIEW CA
94040
US

IV. Provider business mailing address

119 MONROE DRIVE
PALO ALTO CA
94306
US

V. Phone/Fax

Practice location:
  • Phone: 650-917-8348
  • Fax: 650-917-8349
Mailing address:
  • Phone: 650-722-3071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number43018
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: