Individual provider Active NPI

Amanda Jie Huang, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Federal Way, WA
National Provider Identifier
1174551972
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DE60262499 Issued in WA
Practice address
1706 S 320TH St Ste E
Federal Way, WA 98003-5424
Phone
(253) 839-4048
Fax
(253) 839-4046
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE-60262499 WA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DE60262499 WA Primary

Addresses

Primary practice location

1706 S 320TH St Ste E
Federal Way, WA 98003-5424

Mailing address

3002 Shorewood Dr
Mercer Island, WA 98040-3183
Phone (206) 552-1952

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20220314002057 WA Practitioner - Oral SurgeryPractitioner - Dentist 2668867540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Dentist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1706 S 320TH St
Suite E
Federal Way, WA 98003-5424
Phone (253) 839-4048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE-60262499WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Huang and Zhou, PLLC Dentist CurrentSince Jan 28, 2023 Accepting new patients
Amanda Huang DMD LLC CurrentSince Nov 30, 2021 Accepting new patients

Locations

1811 156th Ave NE
Ste 3
Bellevue, WA 98007
Phone (425) 614-1098

1706 S 320th St
Ste E
Federal Way, WA 98003
Phone (253) 839-4048

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1174551972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3002 SHOREWOOD DR",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403183",
            "telephone_number": "206-552-1952",
            "fax_number": "253-839-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 S 320TH ST STE E",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035424",
            "telephone_number": "253-839-4048",
            "fax_number": "253-839-4046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "AMANDA",
        "middle_name": "JIE",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE-60262499",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE60262499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.