Individual provider Active NPI

Yujie Huang, DDS, PHD

  • Endodontics
  • Modesto, CA
National Provider Identifier
1801463708
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
105679 Issued in CA
Practice address
4101 Tully Rd Ste 602
Modesto, CA 95356-8982
Phone
(209) 529-1698
Fax
(209) 529-0058
NPI assigned
Jun 8, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DDS105679 CA
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 105679 CA Primary

Addresses

Primary practice location

4101 Tully Rd Ste 602
Modesto, CA 95356-8982

Mailing address

4101 Tully Rd Ste 602
Modesto, CA 95356-8982
Phone (209) 529-1698

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL dentalhuang@gmail.com

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
I20230118001747 CA Order and Referring Only - DentistPractitioner - Dentist 6305221870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
DDS105679CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Yujie Huang DDS Inc Endodontics CurrentSince Dec 3, 2023 Accepting new patients
Franco a Tarm and Harrison Nguyen DDS MSD a Partnership of Professiona Endodontics PastSince Jul 1, 2022 Accepting new patients

Locations

4101 Tully Rd
Ste 602
Modesto, CA 95356
Phone (209) 529-1698

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": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1801463708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 TULLY RD STE 602",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568982",
            "telephone_number": "209-529-1698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 TULLY RD STE 602",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568982",
            "telephone_number": "209-529-1698",
            "fax_number": "209-529-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "YUJIE",
        "name_prefix": "Dr.",
        "credential": "DDS, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-08",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS105679",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "105679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "dentalhuang@gmail.com",
            "affiliation": "N",
            "address_1": "707 Parnassus Ave # D3000",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941432210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.