Provider Demographics
NPI:1114078227
Name:DUONG, YEN HAI (DDS)
Entity Type:Individual
Prefix:DR
First Name:YEN
Middle Name:HAI
Last Name:DUONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13518 HARBOR BLVD STE A5
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-3840
Mailing Address - Country:US
Mailing Address - Phone:714-530-5517
Mailing Address - Fax:714-530-6526
Practice Address - Street 1:13518 HARBOR BLVD STE A5
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-3840
Practice Address - Country:US
Practice Address - Phone:714-530-5517
Practice Address - Fax:714-530-6526
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA389881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice