Provider Demographics
NPI:1073207577
Name:HUANG, CHING-SHUAN
Entity type:Individual
Prefix:
First Name:CHING-SHUAN
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HARVARD DENTAL CENTER
Mailing Address - Street 2:188 LONGWOOD AVE.
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-432-1434
Mailing Address - Fax:617-432-4258
Practice Address - Street 1:HARVARD DENTAL CENTER
Practice Address - Street 2:188 LONGWOOD AVE.
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-432-1434
Practice Address - Fax:617-432-4258
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2024-11-26
Deactivation Date:2024-01-08
Deactivation Code:
Reactivation Date:2024-11-12
Provider Licenses
StateLicense IDTaxonomies
MADL100143122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist