Provider Demographics
NPI:1386993087
Name:HOANG, ANNE KIM (DDS)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:KIM
Last Name:HOANG
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3945 GALICENO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89122-3435
Mailing Address - Country:US
Mailing Address - Phone:949-394-0955
Mailing Address - Fax:
Practice Address - Street 1:3945 GALICENO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89122-3435
Practice Address - Country:US
Practice Address - Phone:949-394-0955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-10
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61727122300000X
NV63351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist