Provider Demographics
NPI:1265660278
Name:ERIC M. HUANG DDS, PC
Entity Type:Organization
Organization Name:ERIC M. HUANG DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:MIN
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-651-3335
Mailing Address - Street 1:87-08 JUSTICE AVENUE
Mailing Address - Street 2:SUITE #C-L
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-8715
Mailing Address - Country:US
Mailing Address - Phone:718-651-3335
Mailing Address - Fax:718-651-3338
Practice Address - Street 1:87-08 JUSTICE AVENUE
Practice Address - Street 2:SUITE #C-L
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-8715
Practice Address - Country:US
Practice Address - Phone:718-651-3335
Practice Address - Fax:718-651-3338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045308122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01778656Medicaid