=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174682280
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HUANG AND WU DDS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2006
-----------------------------------------------------
Last Update Date | 07/24/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1901 W 8TH ST SUITE E
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90057-4900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-483-8180
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1901 W 8TH ST SUITE E
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90057-4900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-483-8180
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-OWNER,CEO
-----------------------------------------------------
Name | DR. SHIH-YUAN L. HUANG
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 213-483-8180
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 45541
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 41018
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------