Individual provider Active NPI

Naomi Thao Hoang

  • General Practice Dentistry
  • Lynnwood, WA
National Provider Identifier
1629728050
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE61322316 Issued in WA
Practice address
4111 194TH St SW
Lynnwood, WA 98036-4604
Phone
(425) 789-3789
NPI assigned
Mar 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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 DE61322316 WA Primary

Addresses

Primary practice location

4111 194TH St SW
Lynnwood, WA 98036-4604

Mailing address

4111 194TH St SW
Lynnwood, WA 98036-4604
Phone (425) 789-3789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20231219001927 WA Order and Referring Only - DentistPractitioner - Dentist 8729438676

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": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1629728050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 194TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364604",
            "telephone_number": "425-789-3789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 194TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364604",
            "telephone_number": "425-789-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOANG",
        "first_name": "NAOMI",
        "middle_name": "THAO",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-28",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61322316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

Verify at the official NPI Registry.