Provider Demographics
NPI:1518141399
Name:HOANG, CHAU NGOC (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHAU
Middle Name:NGOC
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 1:149 HART ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SHEPPARD AFB
Mailing Address - State:TX
Mailing Address - Zip Code:76311-3477
Mailing Address - Country:US
Mailing Address - Phone:940-676-4474
Mailing Address - Fax:
Practice Address - Street 1:149 HART ST
Practice Address - Street 2:SUITE 4
Practice Address - City:SHEPPARD AFB
Practice Address - State:TX
Practice Address - Zip Code:76311-3477
Practice Address - Country:US
Practice Address - Phone:940-676-4474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23599122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist