MEDICARE: DR. RICHARD HUY DUONG DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	57937	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	26516	OTHER	TX	TEXAS DENTAL LICENSE

General Provider Information

NPI Number	:	1659687671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD HUY DUONG DDS

Provider Business Mailing Address
First Line	:	8731 RATHBURN AVE
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-6816
Country	:	US
Telephone Number	:	310-634-7517
Fax Number	:

Provider Business Practice Location Address
First Line	:	1289 S PARK VICTORIA DR STE 200
Second Line	:
City	:	MILPITAS
State	:	CA
Zip	:	95035-6974
Country	:	US
Telephone Number	:	408-834-3784
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2010
Last Update Date	:	09/27/2019

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