Healthcare Provider Details

I. General information

NPI: 1376647305
Provider Name (Legal Business Name): MARIA T HOANG DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 S WESTERN AVE
OKLAHOMA CITY OK
73139-2002
US

IV. Provider business mailing address

7300 S WESTERN AVE
OKLAHOMA CITY OK
73139-2002
US

V. Phone/Fax

Practice location:
  • Phone: 405-631-4439
  • Fax: 405-632-7905
Mailing address:
  • Phone: 405-631-4439
  • Fax: 405-632-7905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5280
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: