Provider Demographics
NPI:1861831414
Name:HUANG, TAMMY (DMD, MPH)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 COMISO
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-0224
Mailing Address - Country:US
Mailing Address - Phone:949-903-1010
Mailing Address - Fax:
Practice Address - Street 1:16520 BAKE PKWY
Practice Address - Street 2:SUITE #135
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4668
Practice Address - Country:US
Practice Address - Phone:559-788-2532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62450122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist