Healthcare Provider Details

I. General information

NPI: 1477894236
Provider Name (Legal Business Name): HUNG DANG DDS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2013
Last Update Date: 10/13/2020
Certification Date: 10/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15717 PARAMOUNT BLVD STE C
PARAMOUNT CA
90723-4377
US

IV. Provider business mailing address

15717 PARAMOUNT BLVD STE C
PARAMOUNT CA
90723-4377
US

V. Phone/Fax

Practice location:
  • Phone: 562-602-1200
  • Fax:
Mailing address:
  • Phone: 562-602-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number45239
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HUNG N DANG
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 702-501-5818