Provider Demographics
NPI:1447429808
Name:ALLEN HUANG D.M.D., M.S.
Entity Type:Organization
Organization Name:ALLEN HUANG D.M.D., M.S.
Other - Org Name:IMPLANT & PERIODONTAL CENTER OF NEVADA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:WL
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:702-733-0558
Mailing Address - Street 1:2430 E HARMON AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5338
Mailing Address - Country:US
Mailing Address - Phone:702-733-0558
Mailing Address - Fax:702-733-1788
Practice Address - Street 1:2430 E HARMON AVE STE 6
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5338
Practice Address - Country:US
Practice Address - Phone:702-733-0558
Practice Address - Fax:702-733-1788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS7-511223E0200X
NVS4-311223P0300X
NVS4-531223P0300X
NVS3-1211223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty