Individual provider Active NPI

Hai Duc Huynh, DMD

  • Dentist
  • Clearwater, FL
National Provider Identifier
1396419578
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
26122 Issued in FL
Practice address
14100 58TH St N
Clearwater, FL 33760-9900
Phone
(727) 824-8165
NPI assigned
Aug 2, 2021
Last updated
Jul 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 26122 FL Primary

Addresses

Primary practice location

14100 58TH St N
Clearwater, FL 33760-9900

Mailing address

14100 58TH St N
Clearwater, FL 33760-9900
Phone (727) 824-8165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20211027000332 FL Practitioner - Dentist 8224426168 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26122FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of Pinellas Inc. CurrentSince Oct 13, 2021 Accepting new patients
Community Health Center of Pinellas Inc Current Accepting new patients
Community Health Centers of Pinellas Inc. CurrentSince Oct 13, 2021 Accepting new patients
Community Health Center of Pinellas Inc Past Accepting new patients

Locations

14100 58th St N
Clearwater, FL 33760

14100 58th St N
Ste 100
Clearwater, FL 33760
Phone (727) 286-6224

26286 US Highway 19 N
Ste B
Clearwater, FL 33761
Phone (727) 824-8100

5523 Roosevelt Blvd
Clearwater, FL 33760

702 Jasmine Way
Clearwater, FL 33756

12420 130th Ave N
Largo, FL 33774
Phone (727) 587-7729

1344 22nd St S
St Petersburg, FL 33712
Phone (727) 821-6701

4950 34th St N
St Petersburg, FL 33714

721 E Lime St
Tarpon Springs, FL 34689

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1396419578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 58TH ST N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337609900",
            "telephone_number": "727-824-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 58TH ST N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337609900",
            "telephone_number": "727-824-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "HAI",
        "middle_name": "DUC",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-02",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "26122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.