Provider Demographics
NPI:1164525168
Name:HOANG, NANCY LAN (DDS)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LAN
Last Name:HOANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:991 MONTAGUE EXPY STE 203
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6819
Mailing Address - Country:US
Mailing Address - Phone:408-254-2727
Mailing Address - Fax:408-254-2757
Practice Address - Street 1:991 MONTAGUE EXPY STE 203
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-6819
Practice Address - Country:US
Practice Address - Phone:408-254-2727
Practice Address - Fax:408-254-2757
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA470901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9315801OtherDENTI CAL