Provider Demographics
NPI:1154496768
Name:LY, HOA XUONG (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOA
Middle Name:XUONG
Last Name:LY
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 1:1600 E HILL ST
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-3612
Mailing Address - Country:US
Mailing Address - Phone:562-981-4050
Mailing Address - Fax:562-981-5074
Practice Address - Street 1:2360 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-3051
Practice Address - Country:US
Practice Address - Phone:562-595-0731
Practice Address - Fax:562-595-6462
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA468781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice