Provider Demographics
NPI:1366298218
Name:HOANG, NGOCTRAN DANIELLE (DMD)
Entity type:Individual
Prefix:
First Name:NGOCTRAN
Middle Name:DANIELLE
Last Name:HOANG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4252 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1908
Mailing Address - Country:US
Mailing Address - Phone:281-777-4435
Mailing Address - Fax:
Practice Address - Street 1:2070 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:OR
Practice Address - Zip Code:97459-2351
Practice Address - Country:US
Practice Address - Phone:541-756-7568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD119721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice