Healthcare Provider Details

I. General information

NPI: 1578250510
Provider Name (Legal Business Name): HOANG DENTISTRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 SIMMS ST
GOLDEN CO
80401-4792
US

IV. Provider business mailing address

727 SIMMS ST
GOLDEN CO
80401-4792
US

V. Phone/Fax

Practice location:
  • Phone: 303-232-3636
  • Fax:
Mailing address:
  • Phone: 303-232-3636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. DYLAN HOANG
Title or Position: OWNER
Credential: DMD
Phone: 703-638-4290