Provider Demographics
NPI:1740422617
Name:HOANG XUAN, DUY KHIEM (DMD)
Entity Type:Individual
Prefix:
First Name:DUY KHIEM
Middle Name:
Last Name:HOANG XUAN
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 1:95 S SHERIDAN BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-2447
Mailing Address - Country:US
Mailing Address - Phone:720-524-3959
Mailing Address - Fax:720-596-4482
Practice Address - Street 1:95 S SHERIDAN BLVD STE C
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-2447
Practice Address - Country:US
Practice Address - Phone:720-524-3959
Practice Address - Fax:720-596-4482
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO83521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice