Provider Demographics
NPI:1891833372
Name:THANT, AUNG MYO (DDS)
Entity Type:Individual
Prefix:DR
First Name:AUNG
Middle Name:MYO
Last Name:THANT
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 1:110 N ORANGE AVE
Mailing Address - Street 2:# B
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-2032
Mailing Address - Country:US
Mailing Address - Phone:626-927-9223
Mailing Address - Fax:626-927-9223
Practice Address - Street 1:1423 E GAGE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90001-1771
Practice Address - Country:US
Practice Address - Phone:323-983-4000
Practice Address - Fax:323-983-4007
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA524771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice