MEDICARE: MS. TIFFANY HUYNH

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	1223G0001X	General Practice Dentistry	13011	NC

General Provider Information

NPI Number	:	1467024760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TIFFANY HUYNH

Provider Business Mailing Address
First Line	:	125 N FORESTVIEW LN
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60502-7023
Country	:	US
Telephone Number	:	630-632-5345
Fax Number	:

Provider Business Practice Location Address
First Line	:	165 KANDEMOR LN
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27804-3212
Country	:	US
Telephone Number	:	252-443-6443
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2021
Last Update Date	:	02/25/2026

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