Provider Demographics
NPI:1023563939
Name:HOANG DENTAL CORP
Entity Type:Organization
Organization Name:HOANG DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:TRONG
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-233-5887
Mailing Address - Street 1:1356 W VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-2299
Mailing Address - Country:US
Mailing Address - Phone:760-233-5887
Mailing Address - Fax:
Practice Address - Street 1:4750 OCEANSIDE BLVD STE A15
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-3064
Practice Address - Country:US
Practice Address - Phone:760-466-0776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-20
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA476261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty