Provider Demographics
NPI:1477851491
Name:THANG VI DUONG DDS INC
Entity Type:Organization
Organization Name:THANG VI DUONG DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIR
Authorized Official - Prefix:
Authorized Official - First Name:THANG
Authorized Official - Middle Name:VI
Authorized Official - Last Name:DUONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-692-2888
Mailing Address - Street 1:4227 ROSEMEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-1738
Mailing Address - Country:US
Mailing Address - Phone:562-692-2888
Mailing Address - Fax:562-692-7208
Practice Address - Street 1:4227 ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-1738
Practice Address - Country:US
Practice Address - Phone:562-692-2888
Practice Address - Fax:562-692-7208
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THANG VI DUONG DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA498751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty