Individual provider Active NPI

Scott Liem Huynh, D.M.D

  • General Practice Dentistry
  • Jonesboro, GA
National Provider Identifier
1881981074
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN014294 Issued in GA
Practice address
6568 Tara Blvd
Jonesboro, GA 30236-1228
Phone
(770) 961-2000
NPI assigned
Jul 7, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN014294 GA Primary

Addresses

Primary practice location

6568 Tara Blvd
Jonesboro, GA 30236-1228

Mailing address

4336 Hale Dr SW
Lilburn, GA 30047-4114
Phone (404) 819-8267

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20171212001277 GA Order and Referring Only - DentistPractitioner - Dentist 4486949344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN014294GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dentfirst PC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1881981074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4336 HALE DR SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300474114",
            "telephone_number": "404-819-8267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6568 TARA BLVD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361228",
            "telephone_number": "770-961-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "SCOTT",
        "middle_name": "LIEM",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN014294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

Verify at the official NPI Registry.