Provider Demographics
NPI:1033882279
Name:HOANG, DUSTIN THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:THOMAS
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 1:1103 LAVENDER RDG
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-6122
Mailing Address - Country:US
Mailing Address - Phone:512-590-3473
Mailing Address - Fax:
Practice Address - Street 1:4949 HEDGCOXE RD STE 160
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3902
Practice Address - Country:US
Practice Address - Phone:214-387-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-25
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX376371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice