Provider Demographics
NPI:1184030710
Name:HOANG, BRYAN NGUYEN BANG (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:NGUYEN BANG
Last Name:HOANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7171 W CRAIG RD # 102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-6018
Mailing Address - Country:US
Mailing Address - Phone:702-655-0331
Mailing Address - Fax:
Practice Address - Street 1:7171 W CRAIG RD # 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6018
Practice Address - Country:US
Practice Address - Phone:702-655-0331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV66651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice