Healthcare Provider Details

I. General information

NPI: 1669734356
Provider Name (Legal Business Name): KATI N HUYNH D.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2012
Last Update Date: 09/14/2021
Certification Date: 09/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14215 COIT RD STE 112
DALLAS TX
75254-2852
US

IV. Provider business mailing address

14215 COIT RD STE 112
DALLAS TX
75254-2852
US

V. Phone/Fax

Practice location:
  • Phone: 972-701-8282
  • Fax: 972-801-8284
Mailing address:
  • Phone: 972-701-8282
  • Fax: 972-801-8284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number28721
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD008445
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: