Healthcare Provider Details

I. General information

NPI: 1093636227
Provider Name (Legal Business Name): HANG KHANH LUC RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7105 SW HAMPTON ST
TIGARD OR
97223-8314
US

IV. Provider business mailing address

4905 HIBISCUS DR
ARLINGTON TX
76018-1423
US

V. Phone/Fax

Practice location:
  • Phone: 800-813-2000
  • Fax:
Mailing address:
  • Phone: 214-518-9592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH9242
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number28579
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: