Provider Demographics
NPI:1497716930
Name:HENRY HANG-YEE FUNG, D.D.S. INC.
Entity Type:Organization
Organization Name:HENRY HANG-YEE FUNG, D.D.S. INC.
Other - Org Name:HAPPY DENTISTRY & PAIN MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:FUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-721-3312
Mailing Address - Street 1:5424 E BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-2208
Mailing Address - Country:US
Mailing Address - Phone:323-721-3312
Mailing Address - Fax:323-721-8822
Practice Address - Street 1:5424 E BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-2208
Practice Address - Country:US
Practice Address - Phone:323-721-3312
Practice Address - Fax:323-721-8822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30354122300000X, 1223G0001X, 1223S0112X
CAAC001426171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADA0247431OtherBLUE CROSS
CA700367OtherUNITED CONCORDIA
CAG93969-01OtherMEDI-CAL
CAD30354OtherMEDI-CAL
CADE0009034OtherBLUE CROSS
CAZZZ11029ZOtherBLUE CROSS