Provider Demographics
NPI:1487381968
Name:WHANG, JOANNA
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:WHANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4849 FM 1488 RD STE 800
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-4558
Mailing Address - Country:US
Mailing Address - Phone:281-971-2120
Mailing Address - Fax:
Practice Address - Street 1:4849 FM 1488 RD STE 800
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-4558
Practice Address - Country:US
Practice Address - Phone:281-971-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX388271223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice