Provider Demographics
NPI:1295803062
Name:HOANG, HAI DAI (DDS)
Entity type:Individual
Prefix:DR
First Name:HAI
Middle Name:DAI
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 1:5601 NORPOINT WAY NE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422-1369
Mailing Address - Country:US
Mailing Address - Phone:253-927-7118
Mailing Address - Fax:253-573-0272
Practice Address - Street 1:1212 S.11TH ST.
Practice Address - Street 2:#47
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405
Practice Address - Country:US
Practice Address - Phone:253-573-0070
Practice Address - Fax:253-573-0272
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAWA000079721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice