Provider Demographics
NPI:1699722660
Name:HOAG, JOHN SHELDON (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SHELDON
Last Name:HOAG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14434 AMBAUM BLVD SW
Mailing Address - Street 2:SUITE 7
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-1438
Mailing Address - Country:US
Mailing Address - Phone:206-244-4622
Mailing Address - Fax:
Practice Address - Street 1:14434 AMBAUM BLVD SW
Practice Address - Street 2:SUITE 7
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-1438
Practice Address - Country:US
Practice Address - Phone:206-244-4622
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0066661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice