Healthcare Provider Details

I. General information

NPI: 1992761100
Provider Name (Legal Business Name): DICK CHEUNG HUANG DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 JEFFERSON BLVD SUITE A
WEST SACRAMENTO CA
95691-3305
US

IV. Provider business mailing address

1102 JEFFERSON BLVD SUITE A
WEST SACRAMENTO CA
95691-3305
US

V. Phone/Fax

Practice location:
  • Phone: 916-372-5757
  • Fax: 916-372-4791
Mailing address:
  • Phone: 916-372-5757
  • Fax: 916-372-4791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number31284
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: