Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 2901019104 | MI |
Y | 122300000X | Dentist | DT2118 | HI |
NPI | 1003918863 |
---|---|
Provider Name | Xiao-Li Shelly Huang |
First Address | Honolulu, HI 96813-2719 |
Second Address | Honolulu, HI 96813-2719 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 27/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00D0Z55176 | HMSA (01) | HI |
211803 | HDS (01) | HI |
575334 | (05) | HI |