Healthcare Provider Details

I. General information

NPI: 1447926365
Provider Name (Legal Business Name): CONNIE DASSLE HONG DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2021
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5877 S VERMONT AVE
LOS ANGELES CA
90044-3741
US

IV. Provider business mailing address

3150 WILSHIRE BLVD APT 2818
LOS ANGELES CA
90010-1374
US

V. Phone/Fax

Practice location:
  • Phone: 323-759-1523
  • Fax:
Mailing address:
  • Phone: 562-321-0669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number106794
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: