Provider Demographics
NPI:1437159969
Name:HWYNN DENTAL CORPORATION
Entity Type:Organization
Organization Name:HWYNN DENTAL CORPORATION
Other - Org Name:WINNING SMILES DENTAL OFFICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TANI
Authorized Official - Middle Name:
Authorized Official - Last Name:HWYNN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:714-901-0190
Mailing Address - Street 1:5726 E ROCKING HORSE WAY
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-4320
Mailing Address - Country:US
Mailing Address - Phone:714-532-0714
Mailing Address - Fax:714-532-0714
Practice Address - Street 1:14550 MAGNOLIA ST
Practice Address - Street 2:STE 103
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5565
Practice Address - Country:US
Practice Address - Phone:714-901-0190
Practice Address - Fax:714-901-0198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA441871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty