Provider Demographics
NPI:1326183351
Name:HO, WAN HIN HUMPHREY (DDS)
Entity Type:Individual
Prefix:
First Name:WAN HIN HUMPHREY
Middle Name:
Last Name:HO
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 1:5609 CLARION CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-1838
Mailing Address - Country:US
Mailing Address - Phone:512-694-7678
Mailing Address - Fax:512-582-9118
Practice Address - Street 1:12854 RESEARCH BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-3222
Practice Address - Country:US
Practice Address - Phone:512-831-7918
Practice Address - Fax:512-831-7919
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00252911223P0300X, 1223P0300X
AZD0081361223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics