MEDICARE: TRACY TRANG HOANG DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	25492	TX
2	122300000X	Dentist	25492	TX

General Provider Information

NPI Number	:	1184945560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY TRANG HOANG DDS

Provider Business Mailing Address
First Line	:	2819 MASTIL RD
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75054-0048
Country	:	US
Telephone Number	:	469-426-2477
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 SOUTH FWY STE 1550
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76115-1419
Country	:	US
Telephone Number	:	817-924-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2010
Last Update Date	:	08/01/2024

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