Provider Demographics
NPI:1609861483
Name:VUONG, JOANNA TUYET (DMD)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:TUYET
Last Name:VUONG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10301 BOLSA AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-6784
Mailing Address - Country:US
Mailing Address - Phone:714-531-5895
Mailing Address - Fax:
Practice Address - Street 1:10301 BOLSA AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-6784
Practice Address - Country:US
Practice Address - Phone:714-531-5895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2019-01-03
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-30
Provider Licenses
StateLicense IDTaxonomies
CA375141223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics