MEDICARE: JH DENTISTRY LLC

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	DS037977	PA

General Provider Information

NPI Number	:	1588052286
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JH DENTISTRY LLC

Provider Business Mailing Address
First Line	:	255 S 17TH ST
Second Line	:	SUITE 2807
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-6231
Country	:	US
Telephone Number	:	215-546-2311
Fax Number	:	215-546-2312

Provider Business Practice Location Address
First Line	:	255 S 17TH ST
Second Line	:	SUITE 2807
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-6231
Country	:	US
Telephone Number	:	412-915-4823
Fax Number	:	215-546-2312

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JIAN HUANG
Credential	:	DMD
Telephone Number	:	215-546-2311

Provider Enumeration Date	:	01/03/2015
Last Update Date	:	05/03/2016

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Directions to “JH DENTISTRY LLC ” Practice Location

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