Provider Demographics
NPI:1285475954
Name:HOANG, ANTHONY (DMD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:HOANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 TELFORD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST LAWN
Mailing Address - State:PA
Mailing Address - Zip Code:19609-1632
Mailing Address - Country:US
Mailing Address - Phone:302-824-2341
Mailing Address - Fax:
Practice Address - Street 1:803 MOUNTAIN HOME RD
Practice Address - Street 2:
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-9319
Practice Address - Country:US
Practice Address - Phone:302-824-2341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA390200000X
PADS0447991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program