Provider Demographics
NPI:1659801496
Name:HUYNH, HAI NGOC (DMD)
Entity type:Individual
Prefix:DR
First Name:HAI
Middle Name:NGOC
Last Name:HUYNH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 4TH ST UNIT 701
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95021-3030
Mailing Address - Country:US
Mailing Address - Phone:408-931-3370
Mailing Address - Fax:
Practice Address - Street 1:100 4TH ST UNIT 701
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95021-3030
Practice Address - Country:US
Practice Address - Phone:408-931-3370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA1034581223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program