NPIMap

Organization Active NPI

Hoang, Nguyen, & Lu Dental Corp

  • Oral and Maxillofacial Surgery (Dentist)
  • San Diego, CA
National Provider Identifier
1548828221
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
HOANG, NGUYEN, & LU DENTAL CORP
Practice address
9912 Carmel Mountain Rd Ste B
San Diego, CA 92129-2808
Phone
(858) 538-9182
NPI assigned
May 29, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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

Authorized official

Name
Dr. Andy T Hoang, DDSNPI 1477669943
Title
President
Phone
(858) 538-9182

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

9912 Carmel Mountain Rd Ste B
San Diego, CA 92129-2808

Mailing address

9912 Carmel Mountain Rd Ste B
San Diego, CA 92129-2808
Phone (858) 538-9182

Other names 1

  • Rancho Dental Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191106001860 CA Part B Supplier - Clinic/Group Practice 4385976661 Receives reassigned benefits from 4 practitioners
Practice locations: Oceanside, CA; San Diego, CA; Temecula, CA

National Provider Directory

National Provider Directory

Locations

9912 Carmel Mountain Rd
Ste B
San Diego, CA 92129
Phone (858) 538-9182

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600732800000",
    "number": "1548828221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9912 CARMEL MOUNTAIN RD STE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292808",
            "telephone_number": "858-538-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9912 CARMEL MOUNTAIN RD STE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292808",
            "telephone_number": "858-538-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOANG, NGUYEN, & LU DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-29",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A",
        "authorized_official_last_name": "HOANG",
        "authorized_official_first_name": "ANDY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-538-9182",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rancho Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.