Phan Xuan Huynh, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DDS104727 Issued in CA

Practice address

7056 Archibald Ave Ste 105
Eastvale, CA 92880-8714

Phone

(951) 407-1119

NPI assigned

Apr 20, 2016

Reactivated

Sep 25, 2020

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Phan Huynh DDS Ms Apc

  dba Trident Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Eastvale, CA
  • NPI 1871351825

  General Practice

  NPD Authorized official
• An Nguyen DMD Inc

  • Dental Clinic/Center
  • Eastvale, CA
  • NPI 1275227423
  NPD
• Kumar and Stromberg Dental Corporation

  dba My Kids Dentist and Orthodontics Dental Group

  • General Practice Dentistry
  • Hesperia, CA
  • NPI 1770863151
  NPD (past)

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1427402908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12268 OLDENBERG CT",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917399037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7056 ARCHIBALD AVE STE 105",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928808714",
            "telephone_number": "951-407-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "PHAN",
        "middle_name": "XUAN",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-20",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "deactivation_date": "2018-06-13",
        "reactivation_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "DDS104727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Albert Huang, M.D.
• Huey Q Tran, DDS, Inc. (Limonite Dental Group)
• Naomi Veronica Hughes
• Steven Hughes
• Jordan Hung
• Thuy Thien Huynh, RPH
• Brenda Shin-Hwa Hwang, BCBA
• Amy Yen Hy, PHARMD
• Edna Chidinma Ibekwe
• Christine Ikekwere, PHARMD

• Orthodontics and Dentofacial Orthopedics Dentistry in Eastvale, CA
• Providers in Eastvale, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.