Provider Demographics
NPI:1053131409
Name:TUAN LUONG DDS INC
Entity type:Organization
Organization Name:TUAN LUONG DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NGOCHA
Authorized Official - Middle Name:IVY
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-603-3934
Mailing Address - Street 1:2344 MCKEE RD STE 40
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1616
Mailing Address - Country:US
Mailing Address - Phone:408-347-9401
Mailing Address - Fax:408-347-9404
Practice Address - Street 1:2344 MCKEE RD STE 40
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1616
Practice Address - Country:US
Practice Address - Phone:408-347-9401
Practice Address - Fax:408-347-9404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2024-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental