Active NPI
Scott Liem Huynh, D.M.D
- General Practice Dentistry
- Jonesboro, GA
National Provider Identifier
1881981074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN014294
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171212001277 | GA | Order and Referring Only - Dentist | 4486949344 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN014294 | GA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.