Provider Demographics
NPI:1164615324
Name:YUNG TA HUANG DDS INC
Entity Type:Organization
Organization Name:YUNG TA HUANG DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:YUNG-TA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-258-2999
Mailing Address - Street 1:9955 LOWER AZUSA RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-4041
Mailing Address - Country:US
Mailing Address - Phone:626-258-2999
Mailing Address - Fax:626-329-0328
Practice Address - Street 1:9955 LOWER AZUSA RD
Practice Address - Street 2:SUITE 201
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-4041
Practice Address - Country:US
Practice Address - Phone:626-258-2999
Practice Address - Fax:626-329-2328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373391223G0001X
CA414211223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty