Healthcare Provider Details

I. General information

NPI: 1699820548
Provider Name (Legal Business Name): JAMES CHI-HSIN HUANG D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1273 W 7TH ST
UPLAND CA
91786-7069
US

IV. Provider business mailing address

2707 E HILLSIDE DR
WEST COVINA CA
91791-4310
US

V. Phone/Fax

Practice location:
  • Phone: 909-920-9543
  • Fax:
Mailing address:
  • Phone: 626-257-8988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number41421
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: