Provider Demographics
NPI:1467770164
Name:DO, JONATHAN HOANG (DDS)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:HOANG
Last Name:DO
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 1:13422 POMERADO RD STE 101
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-3548
Mailing Address - Country:US
Mailing Address - Phone:858-375-6585
Mailing Address - Fax:
Practice Address - Street 1:13422 POMERADO RD STE 101
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-3548
Practice Address - Country:US
Practice Address - Phone:858-375-6585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA585461223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics