Provider Demographics
NPI:1861914806
Name:DANG, ANH-THU (DMD)
Entity type:Individual
Prefix:DR
First Name:ANH-THU
Middle Name:
Last Name:DANG
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 1:440 PLEASANT HILL RD NW STE 110
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-2781
Mailing Address - Country:US
Mailing Address - Phone:678-716-7700
Mailing Address - Fax:
Practice Address - Street 1:440 PLEASANT HILL RD NW STE 110
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2781
Practice Address - Country:US
Practice Address - Phone:678-716-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN015477122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003218084AMedicaid