Provider Demographics
NPI:1811400377
Name:HO, HOANG-ANH NGUYEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOANG-ANH
Middle Name:NGUYEN
Last Name:HO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 S BARRINGTON AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5300
Mailing Address - Country:US
Mailing Address - Phone:617-777-8543
Mailing Address - Fax:
Practice Address - Street 1:11600 WILSHIRE BLVD STE 504
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1788
Practice Address - Country:US
Practice Address - Phone:310-231-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS102053122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist