Healthcare Provider Details

I. General information

NPI: 1245379791
Provider Name (Legal Business Name): JIAN HUANG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 THOMPSON LN SUITE 334
NASHVILLE TN
37204-3609
US

IV. Provider business mailing address

719 THOMPSON LN SUITE 334
NASHVILLE TN
37204-3609
US

V. Phone/Fax

Practice location:
  • Phone: 615-297-8470
  • Fax: 615-297-8460
Mailing address:
  • Phone: 615-297-8470
  • Fax: 615-297-8460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7573
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: