Ly Khanh Huynh, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D010061 Issued in AZ

Practice address

15409 W Greenway Rd Ste 100
Surprise, AZ 85374-4368

Phone

(623) 546-3511

NPI assigned

Jun 20, 2018

Last updated

Oct 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Aug 14, 2024 through Aug 14, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lhuynh24961@direct.midwestern.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Daniel N Dela Cruz DMD PLLC

  • General Practice Dentistry
  • Surprise, AZ
  • NPI 1588297329
  NPD
• Midwestern University

  dba Midwestern University Dental Institute

  • Dental Clinic/Center
  • Glendale, AZ
  • NPI 1164744009
  NPD (past)
• Midwestern University

  dba Midwestern University Eye Institute

  • Optometrist
  • Glendale, AZ
  • NPI 1891017745
  NPD (past)
• Pavilion Dental Group, LLP

  dba Pavilion Dental Group

  • General Practice Dentistry
  • Peoria, AZ
  • NPI 1568622025
  NPD (past)
• Steele Dental Group

  • Dental Clinic/Center
  • Surprise, AZ
  • NPI 1447728654
  NPD (past)

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728172800000",
    "number": "1114411261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15409 W GREENWAY RD STE 100",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744368",
            "telephone_number": "623-546-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15409 W GREENWAY RD STE 100",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744368",
            "telephone_number": "623-546-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "LY",
        "middle_name": "KHANH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2024-10-06",
        "certification_date": "2024-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devin Hurley
• Carolyn Kaye Hurst, M.A. ED. CCC-SLP
• Cody Hurst, RDN
• Syed Mesum Hussain, MD
• Lamont Hutchinson, PTA
• Quy Huynh
• Stefan Iacob, PA-C
• Hanna Ian, N.M.D.
• Niccolo Iannello, DPT
• David Iannicca, ATC

• General Practice Dentistry in Surprise, AZ
• Providers in Surprise, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.