Provider Demographics
NPI:1558852350
Name:HUANG, SHOU CHIA
Entity Type:Individual
Prefix:
First Name:SHOU CHIA
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 S FIGUEROA ST STE 750
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-2776
Mailing Address - Country:US
Mailing Address - Phone:213-340-3355
Mailing Address - Fax:
Practice Address - Street 1:888 S FIGUEROA ST STE 750
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-2776
Practice Address - Country:US
Practice Address - Phone:213-340-3355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103367122300000X
MADN1857957122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist