Individual provider Active NPI

Kim Thanh Hoang

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1669874319
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
63909 Issued in CA
Practice address
7808 Clairemont Mesa Blvd Ste 101
San Diego, CA 92111-1613
Phone
(858) 598-6789
NPI assigned
Sep 24, 2014
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 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 63909 CA Primary

Addresses

Primary practice location

7808 Clairemont Mesa Blvd Ste 101
San Diego, CA 92111-1613

Mailing address

7808 Clairemont Mesa Blvd Ste 101
San Diego, CA 92111-1613
Phone (858) 598-6789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20251224000449 CA Practitioner - Dentist 3678068970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

21151 S Western Ave
B22
Torrance, CA 90501-1724

3401 Aero Jet Ave
El Monte, CA 91731-2801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63909CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Herald Christian Health Center CurrentSince Dec 1, 2025 Accepting new patients

Locations

3401 Aero Jet Ave
El Monte, CA 91731
Phone (626) 286-8700

7808 Clairemont Mesa Blvd
San Diego, CA 92111
Phone (858) 598-6789

7808 Clairemont Mesa Blvd
Ste 101
San Diego, CA 92111
Phone (858) 598-6789

923 S San Gabriel Blvd
San Gabriel, CA 91776
Phone (626) 286-7018

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1669874319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7808 CLAIREMONT MESA BLVD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111613",
            "telephone_number": "858-598-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7808 CLAIREMONT MESA BLVD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111613",
            "telephone_number": "858-598-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOANG",
        "first_name": "KIM THANH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.