Provider Demographics
NPI:1518452747
Name:HUANG, KUAN CHIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:KUAN CHIA
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:ERIC
Other - Middle Name:
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:10500 NE 8TH ST STE 208
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4351
Mailing Address - Country:US
Mailing Address - Phone:425-688-1345
Mailing Address - Fax:
Practice Address - Street 1:10500 NE 8TH ST STE 208
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4351
Practice Address - Country:US
Practice Address - Phone:425-688-1345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE608607981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice