Individual provider Active NPI

Shayla Hoang My Dang, DMD

  • Student in an Organized Health Care Education/Training Program
  • Glendale, AZ
National Provider Identifier
1356767909
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
19523 N 53Rd Dr
Glendale, AZ 85308-5044
Phone
(850) 566-3335
NPI assigned
Mar 6, 2014
Last updated
Mar 6, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

19523 N 53Rd Dr
Glendale, AZ 85308-5044

Mailing address

19523 N 53Rd Dr
Glendale, AZ 85308-5044
Phone (850) 566-3335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20210203001797 GA Order and Referring Only - DentistPractitioner - Dentist 0840604856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1356767909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19523 N 53RD DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085044",
            "telephone_number": "850-566-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19523 N 53RD DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085044",
            "telephone_number": "850-566-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANG",
        "first_name": "SHAYLA",
        "middle_name": "HOANG MY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.