Provider Demographics
NPI:1629360672
Name:HIRAI, NGAN HUYNH (DMD)
Entity Type:Individual
Prefix:DR
First Name:NGAN
Middle Name:HUYNH
Last Name:HIRAI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:NGAN
Other - Middle Name:HUYNH
Other - Last Name:HIRAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:587 ALLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-2158
Mailing Address - Country:US
Mailing Address - Phone:973-471-7370
Mailing Address - Fax:
Practice Address - Street 1:587 ALLWOOD RD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-2158
Practice Address - Country:US
Practice Address - Phone:973-471-7370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI15895122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist