Provider Demographics
NPI:1396154753
Name:DUONG, VICTORIA (DDS)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:DUONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24000 ALICIA PKWY STE 18
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-3929
Mailing Address - Country:US
Mailing Address - Phone:949-427-2239
Mailing Address - Fax:
Practice Address - Street 1:24000 ALICIA PKWY STE 18
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-3929
Practice Address - Country:US
Practice Address - Phone:949-427-2239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-10
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1013901223X0400X, 1223X0400X
NV65361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA101390OtherDENTAL BOARD OF CALIFORNIA
TX32836OtherTEXAS STATE BOARD OF DENTAL EXAMINERS
NV6536OtherNEVADA STATE BOARD OF DENTAL EXAMINERS