Healthcare Provider Details

I. General information

NPI: 1043099807
Provider Name (Legal Business Name): TIFFANY HUANG MD, DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 06/28/2025
Certification Date: 06/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2206 KAEN RD
OREGON CITY OR
97045-4048
US

IV. Provider business mailing address

3181 SW SAM JACKSON PARK RD FL 7D
PORTLAND OR
97239-3011
US

V. Phone/Fax

Practice location:
  • Phone: 503-722-6777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberD11870
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD11870
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: