Individual provider Active NPI

Long N. Hoang, DMD

  • General Practice Dentistry
  • Titusville, FL
National Provider Identifier
1245463348
Registry record updated Jan 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN18810 Issued in FL
Practice address
3245 Garden St
Titusville, FL 32796-3004
Phone
(321) 269-2700
Fax
(321) 269-6045
NPI assigned
Aug 24, 2009
Last updated
Jan 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN18810 FL Primary

Addresses

Primary practice location

3245 Garden St
Titusville, FL 32796-3004

Mailing address

10815 Arbor View Blvd
Orlando, FL 32825-4423
Phone (352) 256-0165

Other identifiers 1

IdentifierTypeStateIssuer
001400200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20151222002413 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6002117785

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN18810FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Florida P.a. Past Accepting new patients
Coast Florida P.a. PastSince Jun 22, 2021 Accepting new patients

Networks

  • Freedom Health HMO Network

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": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295222400000",
    "number": "1245463348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10815 ARBOR VIEW BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328254423",
            "telephone_number": "352-256-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963004",
            "telephone_number": "321-269-2700",
            "fax_number": "321-269-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOANG",
        "first_name": "LONG",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-24",
        "last_updated": "2011-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001400200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

Verify at the official NPI Registry.