Provider Demographics
NPI:1720209224
Name:HOANG, BINH KIM (DDS)
Entity Type:Individual
Prefix:DR
First Name:BINH
Middle Name:KIM
Last Name:HOANG
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 1:7004 BACKLICK CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-3902
Mailing Address - Country:US
Mailing Address - Phone:703-256-2605
Mailing Address - Fax:703-256-2607
Practice Address - Street 1:7004 BACKLICK CT
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-3902
Practice Address - Country:US
Practice Address - Phone:703-256-2605
Practice Address - Fax:703-256-2607
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014103221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice