Provider Demographics
NPI:1548446594
Name:HUYNH, CANG CARSON (MD, DMD)
Entity type:Individual
Prefix:DR
First Name:CANG
Middle Name:CARSON
Last Name:HUYNH
Suffix:
Gender:M
Credentials:MD, DMD
Other - Prefix:DR
Other - First Name:CARSON
Other - Middle Name:
Other - Last Name:HUYNH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6133 PEACHTREE DUNWOODY RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5332
Mailing Address - Country:US
Mailing Address - Phone:678-412-0311
Mailing Address - Fax:
Practice Address - Street 1:6133 PEACHTREE DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5332
Practice Address - Country:US
Practice Address - Phone:678-412-0311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-20
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0127231223S0112X
GA64391207YS0123X, 2082S0099X, 204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck