Provider Demographics
NPI:1740343730
Name:HUNG K. DO, DDS, INC.
Entity type:Organization
Organization Name:HUNG K. DO, DDS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HUNG
Authorized Official - Middle Name:K
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-683-4255
Mailing Address - Street 1:9561 LAGUNA SPRINGS DR., STE. 100
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758
Mailing Address - Country:US
Mailing Address - Phone:916-683-4255
Mailing Address - Fax:916-683-4256
Practice Address - Street 1:9561 LAGUNA SPRINGS DR., STE. 100
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758
Practice Address - Country:US
Practice Address - Phone:916-683-4255
Practice Address - Fax:916-683-4256
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAGUNA ENDODONTICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-19
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA456811223E0200X
1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty