Healthcare Provider Details

I. General information

NPI: 1114094810
Provider Name (Legal Business Name): WEI HUANG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 MADISON AVE 20TH FLOOR
NEW YORK NY
10017
US

IV. Provider business mailing address

425 MADISON AVE 20TH FLOOR
NEW YORK NY
10017
US

V. Phone/Fax

Practice location:
  • Phone: 212-588-1809
  • Fax: 212-754-0968
Mailing address:
  • Phone: 212-588-1809
  • Fax: 212-754-0968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number048824
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: