Provider Demographics
NPI:1881751816
Name:HWANG, VICTOR R (DMD)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:R
Last Name:HWANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 S DURANGO DR STE 103
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-0179
Mailing Address - Country:US
Mailing Address - Phone:702-384-2828
Mailing Address - Fax:
Practice Address - Street 1:5205 S DURANGO DR STE 103
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-0179
Practice Address - Country:US
Practice Address - Phone:702-384-2828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7013122300000X
MO2019033018122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist