MEDICARE: ALLEN HUANG D.M.D., M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	S7-51	NV
2	1223P0300X	Periodontics	S4-53	NV
3	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	S3-121	NV
4	1223P0300X	Periodontics	S4-31	NV

General Provider Information

NPI Number	:	1447429808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEN HUANG D.M.D., M.S.

Provider Business Mailing Address
First Line	:	2430 E HARMON AVE STE 6
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5338
Country	:	US
Telephone Number	:	702-733-0558
Fax Number	:	702-733-1788

Provider Business Practice Location Address
First Line	:	2430 E HARMON AVE STE 6
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5338
Country	:	US
Telephone Number	:	702-733-0558
Fax Number	:	702-733-1788

Authorized Official
Title or Position	:	PERIODONTIST
Name	:	DR. ALLEN WL HUANG
Credential	:	DMD, MS
Telephone Number	:	702-733-0558

Provider Enumeration Date	:	02/29/2008
Last Update Date	:	02/29/2008

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