Healthcare Provider Details

I. General information

NPI: 1043949464
Provider Name (Legal Business Name): JOCEYLIN HUANG DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 E UNIVERSITY AVE
GEORGETOWN TX
78626-6828
US

IV. Provider business mailing address

13535 LYNDHURST ST APT 8205
AUSTIN TX
78717-0091
US

V. Phone/Fax

Practice location:
  • Phone: 512-863-3379
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number38428
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: