Provider Demographics
NPI:1669511481
Name:HONG, JOSHUA S (DDS)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:S
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 1:750 N. ESTRELLA PARKWAY
Mailing Address - Street 2:SUITE 10
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-9288
Mailing Address - Country:US
Mailing Address - Phone:623-925-8822
Mailing Address - Fax:623-925-1476
Practice Address - Street 1:750 N. ESTRELLA PARKWAY
Practice Address - Street 2:SUITE 10
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-9288
Practice Address - Country:US
Practice Address - Phone:623-925-8822
Practice Address - Fax:623-925-1476
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD5683122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist