Provider Demographics
NPI:1538291299
Name:HUYNH, KIMUYEN HANH (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIMUYEN
Middle Name:HANH
Last Name:HUYNH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 N JACKSON AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1915
Mailing Address - Country:US
Mailing Address - Phone:408-923-8272
Mailing Address - Fax:408-923-8211
Practice Address - Street 1:125 N JACKSON AVE STE 104
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1915
Practice Address - Country:US
Practice Address - Phone:408-923-8272
Practice Address - Fax:408-923-8211
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD51594122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist