Provider Demographics
NPI:1477632438
Name:HUYNH, MICHAEL TRONG (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:TRONG
Last Name:HUYNH
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 1:4343 15TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-1447
Mailing Address - Country:US
Mailing Address - Phone:206-762-1551
Mailing Address - Fax:206-267-1798
Practice Address - Street 1:4343 15TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1447
Practice Address - Country:US
Practice Address - Phone:206-762-1551
Practice Address - Fax:206-267-1798
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000079131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5040241OtherDSHS PROVIDER NUMBER