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General NPI Number Information
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NPI Number | 1750405718
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Entity Type | Organization
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Legal Business Name | DEAN LUONG & DONALD LUONG DDS, INC
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4180 WOODRUFF AVE
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City | LAKEWOOD
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State | CA
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Zip | 90713
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Country | US
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Telephone | 562-938-9514
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Fax | 562-938-9045
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Provider Business Mailing Address
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Address Line | 4180 WOODRUFF AVE
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City | LAKEWOOD
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State | CA
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Zip | 90713
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Country | US
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Telephone | 562-938-9514
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Fax | 562-938-9045
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Authorized Official
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Title or Position | CEO
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Name | DR. DEAN LUONG
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Credential | DDS
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Telephone | 562-938-9514
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | FNP 3534
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License Number State | CA
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