Individual provider Active NPI

Michael D. Hoang

  • General Practice Dentistry
  • West Melbourne, FL
National Provider Identifier
1952830580
Registry record updated Jun 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22679 Issued in FL
Practice address
249 Palm Bay Rd NE
West Melbourne, FL 32904-8602
Phone
(321) 482-5220
NPI assigned
Jun 7, 2017
Last updated
Jun 8, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2017

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 22679 FL Primary

Addresses

Primary practice location

249 Palm Bay Rd NE
West Melbourne, FL 32904-8602

Mailing address

750 Pembroke Ave NE
Palm Bay, FL 32907-1616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210325000035 FL Order and Referring Only - DentistPractitioner - Dentist 1052728755

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22679FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Smiles PLLC General Practice Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1952830580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 PEMBROKE AVE NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 PALM BAY RD NE",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329048602",
            "telephone_number": "321-482-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOANG",
        "first_name": "MICHAEL",
        "middle_name": "D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "22679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Melbourne, FL

Sources for this page

Verify at the official NPI Registry.