Healthcare Provider Details

I. General information

NPI: 1679680920
Provider Name (Legal Business Name): ALLEN WEI-LUN HUANG DMD MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 E HARMON STE #6
LAS VEGAS NV
89121
US

IV. Provider business mailing address

2430 E HARMON STE #6
LAS VEGAS NV
89121
US

V. Phone/Fax

Practice location:
  • Phone: 702-733-0558
  • Fax: 702-733-1788
Mailing address:
  • Phone: 702-733-0558
  • Fax: 702-733-1788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number4601
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: