Healthcare Provider Details

I. General information

NPI: 1386157741
Provider Name (Legal Business Name): SIDA HUANG DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2017
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6877 SW 18TH ST # H120
BOCA RATON FL
33433-7046
US

IV. Provider business mailing address

6877 SW 18TH ST # H120
BOCA RATON FL
33433-7046
US

V. Phone/Fax

Practice location:
  • Phone: 561-393-8250
  • Fax:
Mailing address:
  • Phone: 561-393-8250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN22970
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: