Healthcare Provider Details

I. General information

NPI: 1740109156
Provider Name (Legal Business Name): LAM HUYNH RDH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8050 N EL DORADO ST
STOCKTON CA
95210-2324
US

IV. Provider business mailing address

8050 N EL DORADO ST
STOCKTON CA
95210-2324
US

V. Phone/Fax

Practice location:
  • Phone: 209-598-7737
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberRDH28410
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: