Healthcare Provider Details

I. General information

NPI: 1841353430
Provider Name (Legal Business Name): DAVID HUANG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 COUNTY FARM RD
WEST CHICAGO IL
60185-1568
US

IV. Provider business mailing address

254 COUNTY FARM RD
WEST CHICAGO IL
60185-1568
US

V. Phone/Fax

Practice location:
  • Phone: 630-876-6000
  • Fax: 630-876-6011
Mailing address:
  • Phone: 630-876-6000
  • Fax: 630-876-6011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019025100
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: