Provider Demographics
NPI:1437334638
Name:HUANG, HUNG-JU
Entity Type:Individual
Prefix:MS
First Name:HUNG-JU
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5848 VIA SUSANA
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3604
Mailing Address - Country:US
Mailing Address - Phone:951-778-2642
Mailing Address - Fax:
Practice Address - Street 1:1358 W 6TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3167
Practice Address - Country:US
Practice Address - Phone:951-734-4620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37338122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist