Healthcare Provider Details

I. General information

NPI: 1104079755
Provider Name (Legal Business Name): STEVE J HUANG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 N GREEN VALLEY PKWY SUITE 2E
HENDERSON NV
89074-5885
US

IV. Provider business mailing address

1701 N GREEN VALLEY PKWY SUITE 2E
HENDERSON NV
89074-5885
US

V. Phone/Fax

Practice location:
  • Phone: 949-300-9093
  • Fax:
Mailing address:
  • Phone: 949-300-9093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberCA61212
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number0401415752
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberS2-122
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: