Individual provider Active NPI

Phi Hoang Hua, DDS

  • Dentist
  • Garland, TX
National Provider Identifier
1912436171
Registry record updated Jun 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
33005 Issued in TX
Practice address
4431 W Walnut St Ste a
Garland, TX 75042-4108
Phone
(972) 485-1200
NPI assigned
Jun 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 33005 TX Primary

Addresses

Primary practice location

4431 W Walnut St Ste a
Garland, TX 75042-4108

Mailing address

3010 Redcliff LN
Garland, TX 75043-1155
Phone (214) 603-2171

Other identifiers 1

IdentifierTypeStateIssuer
08195915OtherTXDRIVER LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180731001048 TX Order and Referring Only - DentistPractitioner - Dentist 6901154491

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33005TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Coconut Dental Garland PLLC Current Accepting new patients
Smiley Dental Walnut, PLLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496966400000",
    "number": "1912436171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 REDCLIFF LN",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750431155",
            "telephone_number": "214-603-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4431 W WALNUT ST STE A",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750424108",
            "telephone_number": "972-485-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUA",
        "first_name": "PHI",
        "middle_name": "HOANG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-09",
        "last_updated": "2017-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "33005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "08195915",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.