MEDICARE: RICHARD H DUONG, D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1619528999
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD H DUONG, D.D.S.

Provider Business Mailing Address
First Line	:	8731 RATHBURN AVE
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-6816
Country	:	US
Telephone Number	:	310-634-7517
Fax Number	:

Provider Business Practice Location Address
First Line	:	1289 S PARK VICTORIA DR STE 200
Second Line	:
City	:	MILPITAS
State	:	CA
Zip	:	95035-6974
Country	:	US
Telephone Number	:	408-834-3784
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD DUONG
Credential	:	DDS
Telephone Number	:	310-634-7517

Provider Enumeration Date	:	09/27/2019
Last Update Date	:	09/27/2019

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