Provider Demographics
NPI:1689494718
Name:HUYNH, BICH NGOC (DDS)
Entity type:Individual
Prefix:
First Name:BICH NGOC
Middle Name:
Last Name:HUYNH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1436 CLARKE ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-3635
Mailing Address - Country:US
Mailing Address - Phone:510-939-7246
Mailing Address - Fax:
Practice Address - Street 1:1436 CLARKE ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-3635
Practice Address - Country:US
Practice Address - Phone:510-939-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1105391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice