Provider Demographics
NPI:1932157914
Name:SZETO, VIVIAN ONG (DDS)
Entity Type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:ONG
Last Name:SZETO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:VIVIAN
Other - Middle Name:L
Other - Last Name:ONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:10445 SUMMERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-2331
Mailing Address - Country:US
Mailing Address - Phone:858-566-0796
Mailing Address - Fax:858-566-0796
Practice Address - Street 1:9663 TIERRA GRANDE ST
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4568
Practice Address - Country:US
Practice Address - Phone:858-586-1500
Practice Address - Fax:858-586-1965
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA254351223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics