Provider Demographics
NPI:1902161771
Name:DUONG, JANICE KIEU TIEN (DMD, MSD)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:KIEU TIEN
Last Name:DUONG
Suffix:
Gender:F
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6222 NE 74TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-8158
Mailing Address - Country:US
Mailing Address - Phone:206-543-7906
Mailing Address - Fax:
Practice Address - Street 1:6222 NE 74TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-8158
Practice Address - Country:US
Practice Address - Phone:206-543-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADF605156091223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry