Provider Demographics
NPI:1558092908
Name:HAI HUANG DDS PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:HAI HUANG DDS PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAI
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-834-4321
Mailing Address - Street 1:1900 WEBSTER ST STE A
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2946
Mailing Address - Country:US
Mailing Address - Phone:510-834-4321
Mailing Address - Fax:
Practice Address - Street 1:1900 WEBSTER ST STE A
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2946
Practice Address - Country:US
Practice Address - Phone:510-834-4321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty