Provider Demographics
NPI:1922306810
Name:HOANG, ANDY D (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDY
Middle Name:D
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 1:5722 W MENLO AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-3062
Mailing Address - Country:US
Mailing Address - Phone:559-394-9441
Mailing Address - Fax:
Practice Address - Street 1:11400 GULF FWY
Practice Address - Street 2:SUITE H
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-3549
Practice Address - Country:US
Practice Address - Phone:713-946-2488
Practice Address - Fax:713-946-1369
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX262471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice