Provider Demographics
NPI:1407083827
Name:HOANG, KIM (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:
Last Name:HOANG
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 BRODIE LN
Mailing Address - Street 2:SUITE C-2
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:512-672-7051
Practice Address - Street 1:9001 BRODIE LN
Practice Address - Street 2:SUITE C-2
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:512-672-7051
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX242451223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry