Healthcare Provider Details

I. General information

NPI: 1851118202
Provider Name (Legal Business Name): SARAH HUH DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2024
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2878 CAMPUS PKWY STE 1
RIVERSIDE CA
92507-0945
US

IV. Provider business mailing address

5880 LOCHMOOR DR APT 94
RIVERSIDE CA
92507-8512
US

V. Phone/Fax

Practice location:
  • Phone: 951-571-0011
  • Fax:
Mailing address:
  • Phone: 303-501-2053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number110779
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: