Provider Demographics
NPI:1477671972
Name:NGHIEM, HOANG RICHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOANG
Middle Name:RICHARD
Last Name:NGHIEM
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 1:2356 SE GREEN OAKS BLVD
Mailing Address - Street 2:STE 192
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-0924
Mailing Address - Country:US
Mailing Address - Phone:817-417-0655
Mailing Address - Fax:817-468-8834
Practice Address - Street 1:2356 SE GREEN OAKS BLVD
Practice Address - Street 2:STE 192
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-0924
Practice Address - Country:US
Practice Address - Phone:817-417-0655
Practice Address - Fax:817-468-8834
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX167331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT23461OtherUNITED HEALTHCARE #
PA104717OtherUNITED CONCORDIA #
TX84D494OtherBLUE CROSS BLUE SHIELD #