Provider Demographics
NPI:1619929197
Name:VUONG, NGOC (DDS)
Entity Type:Individual
Prefix:DR
First Name:NGOC
Middle Name:
Last Name:VUONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:NGOC
Other - Last Name:VUONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1102 NE 82ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-5701
Mailing Address - Country:US
Mailing Address - Phone:503-408-8927
Mailing Address - Fax:503-408-8926
Practice Address - Street 1:1102 NE 82ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-5701
Practice Address - Country:US
Practice Address - Phone:503-408-8927
Practice Address - Fax:503-408-8926
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD72621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA898733OtherUNITED CONCORDIA