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General NPI Number Information
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NPI Number | 1649432584
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Entity Type | Individual
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Provider Name | QUYEN VU YING D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 09/28/2015
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Provider Practice Location Address
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Address Line | 830 NE 47TH AVE
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City | PORTLAND
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State | OR
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Zip | 97213-2212
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Country | US
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Telephone | 503-215-1056
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Fax |
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Provider Business Mailing Address
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Address Line | 3348 SW MULTNOMAH BLVD
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City | PORTLAND
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State | OR
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Zip | 97219-3702
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Country | US
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Telephone | 704-502-7798
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 10046
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | D9995
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License Number State | OR
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