Provider Demographics
NPI:1467123976
Name:DO, VICTORIA DUYEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:DUYEN
Last Name:DO
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 1:7173 GASTON AVE APT 1311
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-6134
Mailing Address - Country:US
Mailing Address - Phone:817-774-8907
Mailing Address - Fax:
Practice Address - Street 1:8525 BOAT CLUB RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76179-3600
Practice Address - Country:US
Practice Address - Phone:817-500-5288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37748122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist