Healthcare Provider Details

I. General information

NPI: 1275189771
Provider Name (Legal Business Name): DR. DARREN HUANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2019
Last Update Date: 08/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42-31 COLDEN ST., SUITE#103
FLUSHING NY
11355-3981
US

IV. Provider business mailing address

42-31 COLDEN ST., SUITE#103
FLUSHING NY
11355-3981
US

V. Phone/Fax

Practice location:
  • Phone: 718-461-4435
  • Fax: 718-461-5607
Mailing address:
  • Phone: 718-461-4435
  • Fax: 718-461-5607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number060571
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: