Healthcare Provider Details

I. General information

NPI: 1770109852
Provider Name (Legal Business Name): YIING-SHIUAN HUANG DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LILY HUANG

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 06/29/2020
Certification Date: 06/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 S COLUMBIA ST
CHAPEL HILL NC
27599-0001
US

IV. Provider business mailing address

385 S COLUMBIA ST KOHS 5411 CB#7450
CHAPEL HILL NC
27599-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-537-3737
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number11794
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: