Healthcare Provider Details

I. General information

NPI: 1881391381
Provider Name (Legal Business Name): SELINA HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2023
Last Update Date: 07/07/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330-340 E. 8TH STREET
NATIONAL CITY CA
91911-2312
US

IV. Provider business mailing address

11622 HALLWOOD DR
EL MONTE CA
91732-1436
US

V. Phone/Fax

Practice location:
  • Phone: 619-662-4100
  • Fax:
Mailing address:
  • Phone: 626-233-8165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDDS111202
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: