Healthcare Provider Details

I. General information

NPI: 1225650591
Provider Name (Legal Business Name): HOANG-ANH HO DDS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2020
Last Update Date: 05/10/2020
Certification Date: 05/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 W HUNTINGTON DR STE C
ARCADIA CA
91007-6379
US

IV. Provider business mailing address

461 NOREN ST
LA CANADA CA
91011-2756
US

V. Phone/Fax

Practice location:
  • Phone: 626-792-6109
  • Fax: 626-792-6100
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: HOANG-ANH NGUYEN HO
Title or Position: PRESIDENT
Credential: DDS
Phone: 617-777-8543