Provider Demographics
NPI:1164403994
Name:DANG, THANH K (MD)
Entity type:Individual
Prefix:DR
First Name:THANH
Middle Name:K
Last Name:DANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:THANG
Other - Middle Name:K
Other - Last Name:DANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3601 MINNESOTA DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5202
Mailing Address - Country:US
Mailing Address - Phone:612-879-1000
Mailing Address - Fax:612-879-9116
Practice Address - Street 1:3601 MINNESOTA DR STE 200
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55435-5202
Practice Address - Country:US
Practice Address - Phone:612-879-1000
Practice Address - Fax:612-879-9116
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN379612084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
122798OtherU CARE
206518500OtherMEDICAL ASSISTANCE
09 15 1998OtherMMSI
785177OtherST CLOUD HOSPITAL
1507269OtherMEDICA HEALTH PLANS
HP26416OtherHEALTH PARTNERS
130017755OtherRR MEDICARE
45Q89DAOtherBLUE CROSS BLUE SHIELD
1016683OtherPREFERRED ONE
2116641OtherFIRST HEALTH PLAN
785177OtherARAZ GRP AMERICA'S PPO
09 15 1998OtherMMSI
130017755OtherRR MEDICARE