Provider Demographics
NPI:1306947825
Name:HUANG, ANDERSON T (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDERSON
Middle Name:T
Last Name:HUANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4231 COLDEN ST
Mailing Address - Street 2:SUITE # 103
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3977
Mailing Address - Country:US
Mailing Address - Phone:718-461-4435
Mailing Address - Fax:718-461-5607
Practice Address - Street 1:4231 COLDEN ST
Practice Address - Street 2:SUITE # 103
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3977
Practice Address - Country:US
Practice Address - Phone:718-461-4435
Practice Address - Fax:718-461-5607
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042974-11223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01568381Medicaid