Healthcare Provider Details

I. General information

NPI: 1134481245
Provider Name (Legal Business Name): RAY MIN-HSIUNG HUANG D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2012
Last Update Date: 05/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 140TH AVE NE
BELLEVUE WA
98005-2973
US

IV. Provider business mailing address

8829 NE 24TH ST
CLYDE HILL WA
98004-2426
US

V. Phone/Fax

Practice location:
  • Phone: 206-399-2693
  • Fax:
Mailing address:
  • Phone: 206-399-2693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE60326656
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: