Provider Demographics
NPI:1497783724
Name:HOANG, ANTHONY N (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:N
Last Name:HOANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 RADIO DRIVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292
Mailing Address - Country:US
Mailing Address - Phone:336-236-9497
Mailing Address - Fax:336-236-9555
Practice Address - Street 1:672 RADIO DRIVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292
Practice Address - Country:US
Practice Address - Phone:336-236-9497
Practice Address - Fax:336-236-9555
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC72881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89902NWMedicaid
NC902NWOtherBLUE CROSS BLUE SHIELD