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General NPI Number Information
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NPI Number | 1851957278
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Entity Type | Organization
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Legal Business Name | JAVID & LUONG DENTAL
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Dates
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Enumeration Date | 05/10/2019
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 3831 HUGHES AVE STE 102
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City | CULVER CITY
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State | CA
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Zip | 90232-6834
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Country | US
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Telephone | 714-855-6863
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Fax |
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Provider Business Mailing Address
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Address Line | 3831 HUGHES AVE STE 102
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City | CULVER CITY
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State | CA
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Zip | 90232-6834
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Country | US
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Telephone | 714-855-6863
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. VIVIAN LUONG
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Credential | DDS
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Telephone | 714-855-6863
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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