Provider Demographics
NPI:1407352099
Name:HUH, JEE HYE (DMD)
Entity Type:Individual
Prefix:
First Name:JEE HYE
Middle Name:
Last Name:HUH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:AMY JEE HYE
Other - Middle Name:
Other - Last Name:HUH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:11092 ANDERSON STREET PRINCE HALL 3301
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92350-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11092 ANDERSON ST PRINCE HALL 1452
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92350-4330
Practice Address - Country:US
Practice Address - Phone:909-558-4689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2018-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102347122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist