Provider Demographics
NPI:1114395795
Name:HUYNH, JENNIFER (DMD, MPH, MS)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:HUYNH
Suffix:
Gender:F
Credentials:DMD, MPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 TORRANCE BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4824
Mailing Address - Country:US
Mailing Address - Phone:310-543-2711
Mailing Address - Fax:310-540-1471
Practice Address - Street 1:3510 TORRANCE BLVD STE 210
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4824
Practice Address - Country:US
Practice Address - Phone:310-543-2711
Practice Address - Fax:310-540-1471
Is Sole Proprietor?:No
Enumeration Date:2015-09-12
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1046611223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics