Provider Demographics
NPI:1528091279
Name:DUONG, NHA TRUNG (DDS)
Entity type:Individual
Prefix:DR
First Name:NHA
Middle Name:TRUNG
Last Name:DUONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2836 NW 23RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-2214
Mailing Address - Country:US
Mailing Address - Phone:405-943-9010
Mailing Address - Fax:405-943-9280
Practice Address - Street 1:2836 NW 23RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-2214
Practice Address - Country:US
Practice Address - Phone:405-943-9010
Practice Address - Fax:405-943-9280
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK556381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice