Provider Demographics
NPI:1518322247
Name:HUANG, ALLEN (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 E 4TH ST STE M
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-2606
Mailing Address - Country:US
Mailing Address - Phone:909-984-7872
Mailing Address - Fax:
Practice Address - Street 1:23550 HAWTHORNE BLVD STE 180
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4721
Practice Address - Country:US
Practice Address - Phone:424-241-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-22
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65099122300000X
CADDS650991223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist