Provider Demographics
NPI:1821170374
Name:HOANG, SCOTT ANH (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ANH
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 1:433 ESTUDILLO AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4915
Mailing Address - Country:US
Mailing Address - Phone:510-895-1977
Mailing Address - Fax:510-895-2297
Practice Address - Street 1:433 ESTUDILLO AVE STE 204
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4915
Practice Address - Country:US
Practice Address - Phone:510-895-1977
Practice Address - Fax:510-895-2297
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA443221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice