Provider Demographics
NPI:1306800685
Name:HUANG, STANLEY JIANFENG
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:JIANFENG
Last Name:HUANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4617 FREEPORT BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-2015
Mailing Address - Country:US
Mailing Address - Phone:916-456-2688
Mailing Address - Fax:916-456-3688
Practice Address - Street 1:4617 FREEPORT BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-2015
Practice Address - Country:US
Practice Address - Phone:916-456-2688
Practice Address - Fax:916-456-3688
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA491121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice