Provider Demographics
NPI:1083126916
Name:JACQUELINE DUONG DMD PLLC
Entity Type:Organization
Organization Name:JACQUELINE DUONG DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUONG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:713-516-4155
Mailing Address - Street 1:8282 BELLAIRE BLVD STE 147
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-4031
Mailing Address - Country:US
Mailing Address - Phone:713-778-0100
Mailing Address - Fax:
Practice Address - Street 1:8282 BELLAIRE BLVD STE 147
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4031
Practice Address - Country:US
Practice Address - Phone:713-778-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX283591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty