Healthcare Provider Details

I. General information

NPI: 1306530282
Provider Name (Legal Business Name): DIANA DUONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7281 WYOMING ST APT 2
WESTMINSTER CA
92683-8722
US

IV. Provider business mailing address

7281 WYOMING ST APT 2
WESTMINSTER CA
92683-8722
US

V. Phone/Fax

Practice location:
  • Phone: 714-653-0563
  • Fax:
Mailing address:
  • Phone: 714-653-0563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number113380
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: