Provider Demographics
NPI:1154559938
Name:NGUYEN, HOANG LUONG (DDS)
Entity type:Individual
Prefix:DR
First Name:HOANG
Middle Name:LUONG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:PHILIP
Other - Middle Name:LUONG
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:2104 S KING ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-2232
Mailing Address - Country:US
Mailing Address - Phone:808-949-6608
Mailing Address - Fax:808-946-4555
Practice Address - Street 1:2104 S KING ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-2232
Practice Address - Country:US
Practice Address - Phone:808-949-6608
Practice Address - Fax:808-946-4555
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT 23761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice