Individual provider Active NPI

Tuan Manh Hoang, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Anaheim, CA
National Provider Identifier
1215307954
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
61794 Issued in CA
Practice address
1317 S. Courtright Street
Anaheim, CA 92804
Phone
(714) 425-0735
NPI assigned
Oct 6, 2015
Last updated
Oct 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 61794 CA Primary

Addresses

Primary practice location

1317 S. Courtright Street
Anaheim, CA 92804

Mailing address

1317 S. Courtright Street
Anaheim, CA 92804
Phone (714) 425-0735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190315001816 CA Practitioner - Oral Surgery 1951695923

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
61794CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Tuan Manh Hoang DDS Inc Oral and Maxillofacial Surgery Current Accepting new patients
Tuan M. Hoang, DDS Inc. Oral and Maxillofacial Surgery CurrentSince Sep 25, 2018 Accepting new patients

Locations

16045 Brookhurst St
Fountain Valley, CA 92708
Phone (657) 900-2208

Interoperability endpoints

  • Direct secure messaging: thoang812872@direct.memorialcare.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1215307954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 S. COURTRIGHT STREET",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92804",
            "telephone_number": "714-425-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 S. COURTRIGHT STREET",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92804",
            "telephone_number": "714-425-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOANG",
        "first_name": "TUAN",
        "middle_name": "MANH",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "61794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.