Healthcare Provider Details

I. General information

NPI: 1871624197
Provider Name (Legal Business Name): DANIEL J HUANG D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 04/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13620 38TH AVE STE 6J
FLUSHING NY
11354-4233
US

IV. Provider business mailing address

13620 38TH AVE STE 6J
FLUSHING NY
11354-4233
US

V. Phone/Fax

Practice location:
  • Phone: 718-939-4734
  • Fax: 718-886-5588
Mailing address:
  • Phone: 718-939-4734
  • Fax: 718-886-5588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberNY043668
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: