Healthcare Provider Details

I. General information

NPI: 1164436200
Provider Name (Legal Business Name): HUYEN T HOANG DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST MC 7782
DENVER CO
80204-4507
US

IV. Provider business mailing address

14665 W AMHERST PL
LAKEWOOD CO
80228-4866
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number8812
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: