Provider Demographics
NPI:1982694055
Name:DUONG, JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:DUONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8410 W THOMAS RD
Mailing Address - Street 2:BUILDING 2, SUITE 114
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-3329
Mailing Address - Country:US
Mailing Address - Phone:623-247-5800
Mailing Address - Fax:
Practice Address - Street 1:8410 W THOMAS RD
Practice Address - Street 2:BUILDING 2, SUITE 114
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3329
Practice Address - Country:US
Practice Address - Phone:702-686-3308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2014-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD6706122300000X
NV5526122300000X
FLDN17152122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ973471Medicaid