MEDICARE: DR. LAN KIM DOAN D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	23391	TX

General Provider Information

NPI Number	:	1730316530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAN KIM DOAN D.D.S

Provider Business Mailing Address
First Line	:	1718 COTTAGE LANDING LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-1923
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11322 BELLAIRE BLVD
Second Line	:	STE 112
City	:	HOUSTON
State	:	TX
Zip	:	77072-5700
Country	:	US
Telephone Number	:	281-498-1100
Fax Number	:	281-498-1102

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2009
Last Update Date	:	12/07/2016

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