1205987070 NPI number — HOA QUYNH DUONG D.D.S. & YEN HAI DUONG D.D.S., INC.

Table of content: (NPI 1205987070)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205987070 NPI number — HOA QUYNH DUONG D.D.S. & YEN HAI DUONG D.D.S., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOA QUYNH DUONG D.D.S. & YEN HAI DUONG D.D.S., INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205987070
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13518 HARBOR BLVD STE A5
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GARDEN GROVE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92843-3840
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-530-5517
Provider Business Mailing Address Fax Number:
714-530-6526

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13518 HARBOR BLVD
Provider Second Line Business Practice Location Address:
A5
Provider Business Practice Location Address City Name:
GARDEN GROVE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92843-3838
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-530-5517
Provider Business Practice Location Address Fax Number:
714-530-6526
Provider Enumeration Date:
01/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DUONG
Authorized Official First Name:
HOA
Authorized Official Middle Name:
QUYNH
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
714-530-5517

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X , with the licence number:  35876 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com