Healthcare Provider Details

I. General information

NPI: 1699085985
Provider Name (Legal Business Name): LYNH THUY HOANG D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2010
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35110 ARBORDALE CT
FREMONT CA
94536-2404
US

IV. Provider business mailing address

35110 ARBORDALE CT
FREMONT CA
94536-2404
US

V. Phone/Fax

Practice location:
  • Phone: 510-673-5604
  • Fax:
Mailing address:
  • Phone: 510-673-5604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number59741
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number59741
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: