Provider Demographics
NPI:1063501716
Name:HUNG, TIMOTHY TRANG-MING (DDS)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:TRANG-MING
Last Name:HUNG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5844 ENCINITA AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-2420
Mailing Address - Country:US
Mailing Address - Phone:626-458-2788
Mailing Address - Fax:
Practice Address - Street 1:617 S ATLANTIC BLVD # A
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-3817
Practice Address - Country:US
Practice Address - Phone:626-458-2788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA264311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice