Provider Demographics
NPI:1003120627
Name:HOANG, AUSTIN MINH (DDS)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:MINH
Last Name:HOANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 SHADY BROOK LN
Mailing Address - Street 2:APT #116
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-1203
Mailing Address - Country:US
Mailing Address - Phone:870-723-5140
Mailing Address - Fax:
Practice Address - Street 1:7620 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-7512
Practice Address - Country:US
Practice Address - Phone:214-414-3742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00257821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice