Healthcare Provider Details

I. General information

NPI: 1972422731
Provider Name (Legal Business Name): TIEN HOANG DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12816 SE 38TH ST STE I
BELLEVUE WA
98006-1327
US

IV. Provider business mailing address

12816 SE 38TH ST STE I
BELLEVUE WA
98006-1327
US

V. Phone/Fax

Practice location:
  • Phone: 228-437-5263
  • Fax:
Mailing address:
  • Phone:
  • 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: TIEN HOANG
Title or Position: MEMBER
Credential: DMD
Phone: 228-437-5263