Provider Demographics
NPI:1245815018
Name:HO, HUONG THIEN (DMD)
Entity type:Individual
Prefix:
First Name:HUONG
Middle Name:THIEN
Last Name:HO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 BLOSSOM HILL RD SPC 139
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-5910
Mailing Address - Country:US
Mailing Address - Phone:408-355-8468
Mailing Address - Fax:
Practice Address - Street 1:165 BLOSSOM HILL RD SPC 139
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-5910
Practice Address - Country:US
Practice Address - Phone:408-355-8468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-13
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1091691223X0008X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223X0008XDental ProvidersDentistOral and Maxillofacial Radiology