Provider Demographics
NPI:1710019161
Name:HUANG, JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 EL CAMINO REAL STE 100
Mailing Address - Street 2:
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-1270
Mailing Address - Country:US
Mailing Address - Phone:650-989-8711
Mailing Address - Fax:650-989-8704
Practice Address - Street 1:1641 EL CAMINO REAL STE 100
Practice Address - Street 2:
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-1270
Practice Address - Country:US
Practice Address - Phone:650-989-8711
Practice Address - Fax:650-989-8704
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA259071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice