Provider Demographics
NPI:1457821209
Name:HUANG, JAMES (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13072 BOSTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-5935
Mailing Address - Country:US
Mailing Address - Phone:626-552-5246
Mailing Address - Fax:
Practice Address - Street 1:31571 CANYON ESTATES DR STE 200
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92532-0412
Practice Address - Country:US
Practice Address - Phone:951-471-8979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1030131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice