Active NPI
Nam Hoang
- Dentist
- Urbana, IL
National Provider Identifier
1255853446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 018.002021
- Practice address
- 611 W Park St
Urbana, IL 61801-2529 - Phone
- (217) 383-3311
- NPI assigned
- Jul 10, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 018.002021 | IL | Primary |
Addresses
Primary practice location
611 W Park St
Urbana, IL 61801-2529
Mailing address
1125 Baytowne Dr Apt 28
Champaign, IL 61822-7979
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018.002021 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499644800000",
"number": "1255853446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1125 BAYTOWNE DR APT 28",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618227979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 W PARK ST",
"city": "URBANA",
"state": "IL",
"postal_code": "618012529",
"telephone_number": "217-383-3311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOANG",
"first_name": "NAM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-07-10",
"last_updated": "2017-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "018.002021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Urbana, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.