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General NPI Number Information
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NPI Number | 1952698482
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Entity Type | Individual
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Provider Name | PHI LUONG D.D.S
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Gender | Female
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Dates
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Enumeration Date | 07/05/2011
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 2591 MAIN ST
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City | OAKLEY
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State | CA
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Zip | 94561-1854
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Country | US
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Telephone | 925-690-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 2591 MAIN ST
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City | OAKLEY
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State | CA
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Zip | 94561-1854
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Country | US
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Telephone |
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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 | S6-133C
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License Number State | NV
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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 | 63530
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License Number State | CA
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