Healthcare Provider Details

I. General information

NPI: 1538170758
Provider Name (Legal Business Name): FRANK CHINFU HUANG D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 08/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 W ROBINHOOD DR SUITE 5A
STOCKTON CA
95207-5624
US

IV. Provider business mailing address

1150 W ROBINHOOD DR SUITE 5A
STOCKTON CA
95207-5624
US

V. Phone/Fax

Practice location:
  • Phone: 209-952-6902
  • Fax: 209-952-3608
Mailing address:
  • Phone: 209-952-6902
  • Fax: 209-952-3608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberB35271
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number35271
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: