Provider Demographics
NPI:1770511909
Name:DUONG, TANH XUAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:TANH
Middle Name:XUAN
Last Name:DUONG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 SUNCAST LN
Mailing Address - Street 2:STE. 1
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9329
Mailing Address - Country:US
Mailing Address - Phone:916-939-8128
Mailing Address - Fax:
Practice Address - Street 1:1190 SUNCAST LN
Practice Address - Street 2:STE. 1
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9329
Practice Address - Country:US
Practice Address - Phone:916-939-8128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA408091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice