Provider Demographics
NPI:1376078493
Name:DUONG, GIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:GIA
Middle Name:
Last Name:DUONG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1499 MASSACHUSETTS AVE NW APT 813
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-2859
Mailing Address - Country:US
Mailing Address - Phone:908-416-0269
Mailing Address - Fax:
Practice Address - Street 1:1499 MASSACHUSETTS AVE NW APT 813
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-2859
Practice Address - Country:US
Practice Address - Phone:908-416-0269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014168831223P0221X
MI29010223191223P0221X
DCDEN10020901223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry