Provider Demographics
NPI:1538686829
Name:HUYNH, JOANNE (RDH, PHDHP)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:HUYNH
Suffix:
Gender:F
Credentials:RDH, PHDHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1538 MORRIS ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-2239
Mailing Address - Country:US
Mailing Address - Phone:215-391-6229
Mailing Address - Fax:
Practice Address - Street 1:4700 WISSAHICKON AVE BLDG D
Practice Address - Street 2:SUITE 110-B
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-4248
Practice Address - Country:US
Practice Address - Phone:267-597-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2017-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH070423124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist