=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427672286
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DIANA HUYNH DDS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/07/2020
-----------------------------------------------------
Last Update Date | 07/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 181 TOWN CENTER BLVD STE 100
-----------------------------------------------------
City | JARRELL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76537-4002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-746-5222
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3820 BRAM CV
-----------------------------------------------------
City | ROUND ROCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78681-2352
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-371-2513
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 39048
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------