Provider Demographics
NPI:1629128681
Name:HONG, LOUIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:HONG
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 1:1041 FREEDOM BLVD
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-3263
Mailing Address - Country:US
Mailing Address - Phone:831-768-0707
Mailing Address - Fax:831-768-0155
Practice Address - Street 1:1041 FREEDOM BLVD
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-3263
Practice Address - Country:US
Practice Address - Phone:831-768-0707
Practice Address - Fax:831-768-0155
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA462661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice