Provider Demographics
NPI:1255458782
Name:HOANG, THUONG DOMINIC (DDS)
Entity type:Individual
Prefix:DR
First Name:THUONG
Middle Name:DOMINIC
Last Name:HOANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 ALMA DR
Mailing Address - Street 2:SUITE #101
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-2006
Mailing Address - Country:US
Mailing Address - Phone:469-467-8007
Mailing Address - Fax:469-467-8011
Practice Address - Street 1:6800 ALMA DR
Practice Address - Street 2:SUITE #101
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-2006
Practice Address - Country:US
Practice Address - Phone:469-467-8007
Practice Address - Fax:469-467-8011
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB20583-01OtherTX-CHIP
TX1341891OtherUNITED CONCORDIA
TX147438901Medicaid