Healthcare Provider Details

I. General information

NPI: 1962423517
Provider Name (Legal Business Name): LINDA L HUANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131-07 40TH ROAD, SUITE E35
FLUSHING NY
11354
US

IV. Provider business mailing address

131-07 40TH ROAD, SUITE E35
FLUSHING NY
11354
US

V. Phone/Fax

Practice location:
  • Phone: 718-888-9866
  • Fax: 718-532-9685
Mailing address:
  • Phone: 718-888-9866
  • Fax: 718-532-9685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number049201
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number234273
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: