Provider Demographics
NPI:1063636272
Name:HUANG, SHENG-JIA CYNTHIA (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:SHENG-JIA
Middle Name:CYNTHIA
Last Name:HUANG
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18800 MAIN ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1707
Mailing Address - Country:US
Mailing Address - Phone:714-847-0808
Mailing Address - Fax:714-847-0808
Practice Address - Street 1:18800 MAIN ST
Practice Address - Street 2:SUITE 210
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1707
Practice Address - Country:US
Practice Address - Phone:714-847-0808
Practice Address - Fax:714-847-0808
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA482911223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA200-73-9927OtherDELTA DENTAL TIN