Provider Demographics
NPI:1245575232
Name:KIM HOANG DDS PLLC
Entity Type:Organization
Organization Name:KIM HOANG DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-280-2266
Mailing Address - Street 1:9001 BRODIE LN
Mailing Address - Street 2:C2
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-5002
Mailing Address - Country:US
Mailing Address - Phone:512-280-2266
Mailing Address - Fax:512-280-2276
Practice Address - Street 1:9001 BRODIE LN
Practice Address - Street 2:C2
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5002
Practice Address - Country:US
Practice Address - Phone:512-280-2266
Practice Address - Fax:512-280-2276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX242451223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty