Individual provider Active NPI

Ryan Zhong-Wei Huang I, DDS

  • Dentist
  • San Fernando, CA
National Provider Identifier
1063605483
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
56071 Issued in CA
Practice address
1600 San Fernando Rd
San Fernando, CA 91340-3115
Phone
(818) 898-1388
Fax
(818) 270-9570
NPI assigned
Aug 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 56071 CA Primary

Addresses

Primary practice location

1600 San Fernando Rd
San Fernando, CA 91340-3115

Mailing address

300 W Grand Ave Apt 23
Alhambra, CA 91801-7219
Phone (626) 872-0836

Other identifiers 1

IdentifierTypeStateIssuer
D56071MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190302000150 CA Order and Referring Only - DentistPractitioner - Dentist 0749529170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: ryan.huang.p1@direct.scfhc.nextgenshare.com
  • Direct secure messaging: ryan.huang.p1@direct.cscla.nextgenshare.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1063605483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W GRAND AVE APT 23",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918017219",
            "telephone_number": "626-872-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SAN FERNANDO RD",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913403115",
            "telephone_number": "818-898-1388",
            "fax_number": "818-270-9570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "RYAN",
        "middle_name": "ZHONG-WEI",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D56071",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Fernando, CA

Sources for this page

Verify at the official NPI Registry.