Healthcare Provider Details

I. General information

NPI: 1649524794
Provider Name (Legal Business Name): AHRIN HUH D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2012
Last Update Date: 10/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 TEANECK RD
TEANECK NJ
07666-4242
US

IV. Provider business mailing address

1117 SAGE CT
MAHWAH NJ
07430-2341
US

V. Phone/Fax

Practice location:
  • Phone: 201-723-8371
  • Fax:
Mailing address:
  • Phone: 201-723-8371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number22DI02516300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number056468-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: