Provider Demographics
NPI:1326133141
Name:NGUYEN, HOANG THANH (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOANG
Middle Name:THANH
Last Name:NGUYEN
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 1:4233 W CENTURY BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90304-3646
Mailing Address - Country:US
Mailing Address - Phone:310-671-8535
Mailing Address - Fax:
Practice Address - Street 1:4233 W CENTURY BLVD STE 4
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90304-3646
Practice Address - Country:US
Practice Address - Phone:310-671-8535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA372681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice