Provider Demographics
NPI:1578733788
Name:DANE HOANG, DDS, MS., PA
Entity Type:Organization
Organization Name:DANE HOANG, DDS, MS., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANE
Authorized Official - Middle Name:THUIY LE
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS, PA
Authorized Official - Phone:972-234-4500
Mailing Address - Street 1:9788 WALNUT ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-4841
Mailing Address - Country:US
Mailing Address - Phone:972-234-4500
Mailing Address - Fax:972-234-4562
Practice Address - Street 1:9788 WALNUT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-4841
Practice Address - Country:US
Practice Address - Phone:972-234-4500
Practice Address - Fax:972-234-4562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX188431223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151607201Medicaid