Provider Demographics
NPI:1760828156
Name:GHI, HUEYCHUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:HUEYCHUNG
Middle Name:
Last Name:GHI
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 1:13640 39TH AVE
Mailing Address - Street 2:SUITE#402
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5536
Mailing Address - Country:US
Mailing Address - Phone:718-886-0900
Mailing Address - Fax:718-886-0999
Practice Address - Street 1:13640 39TH AVE
Practice Address - Street 2:SUITE#402
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5536
Practice Address - Country:US
Practice Address - Phone:718-886-0900
Practice Address - Fax:718-886-0999
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0360291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00696731Medicaid