Provider Demographics
NPI:1770065963
Name:HOANG, MICHAEL TUAN (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:TUAN
Last Name:HOANG
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 HILGARD AVE APT 304
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-3629
Mailing Address - Country:US
Mailing Address - Phone:310-871-9633
Mailing Address - Fax:
Practice Address - Street 1:23838 VALENCIA BLVD
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5319
Practice Address - Country:US
Practice Address - Phone:661-259-2960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1023721223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty