Provider Demographics
NPI:1164070215
Name:HUYNH, DANIEL DAT (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:DAT
Last Name:HUYNH
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 1:2661 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-2309
Mailing Address - Country:US
Mailing Address - Phone:626-213-7420
Mailing Address - Fax:
Practice Address - Street 1:100 E HUNTINGTON DR STE 206
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-1022
Practice Address - Country:US
Practice Address - Phone:626-308-7881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-02
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS104318122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist