Thavisab Noy Hatlavongsa, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

49898 Issued in CA

Practice address

29798 Haun Rd Ste 306
Sun City, CA 92586-6542

Phone

(951) 672-0717

Fax

(951) 848-0883

NPI assigned

Apr 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265655229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29798 HAUN RD STE 306",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925866542",
            "telephone_number": "951-672-0717",
            "fax_number": "951-848-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29798 HAUN RD STE 306",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925866542",
            "telephone_number": "951-672-0717",
            "fax_number": "951-848-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATLAVONGSA",
        "first_name": "THAVISAB",
        "middle_name": "NOY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Hanley, FNP-BC
• Sandy Hanna, OD
• Todd Christopher Hanna, M.D.
• Guadalupe Haro Trujillo
• Donna Hastert, P.A.-C
• Hematology/Oncology Consultants
• Hemet Emergency Med Group @ Menifee Hospital
• Christine Nareen Hermiz, DO
• Tanya Hirmiz
• Hope Hospice & Healthcare, Inc.

• All providers in Sun City, CA
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.