Provider Demographics
NPI:1609269174
Name:DOAN, THUYQUYEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:THUYQUYEN
Middle Name:
Last Name:DOAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JUSTENE
Other - Middle Name:
Other - Last Name:DOAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3780 EL CAJON BLVD # 1
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-1080
Mailing Address - Country:US
Mailing Address - Phone:619-265-2467
Mailing Address - Fax:619-265-2196
Practice Address - Street 1:3780 EL CAJON BLVD # 1
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-1080
Practice Address - Country:US
Practice Address - Phone:619-265-2467
Practice Address - Fax:619-265-2196
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49874122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist