Provider Demographics
NPI:1700322716
Name:HOANG, ANN NGUYEN (DMD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:NGUYEN
Last Name:HOANG
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 1:7580 E TECHNOLOGY WAY
Mailing Address - Street 2:APT 207
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7975 ALLISON WAY
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-4428
Practice Address - Country:US
Practice Address - Phone:303-421-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-13
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL212781223G0001X
390200000X
CO002031271223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program