Dominique Duong, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DN015115 Issued in GA

Practice address

5430 Jimmy Carter Blvd Ste 125
Norcross, GA 30093-1526

Phone

(770) 441-7900

NPI assigned

Dec 29, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Norcross Dental Center

  • Dentist
  • Norcross, GA
  • NPI 1023283181
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1093170458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5840 BEAVER RIDGE DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300400242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 JIMMY CARTER BLVD STE 125",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300931526",
            "telephone_number": "770-441-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUONG",
        "first_name": "DOMINIQUE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-29",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN015115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Duluth Healthcare Systems LLC
• Glendia Rashaun Dunkin, MSW
• Elizabeth C Dunn, R.PH.
• Alexis Dunton
• Dunwoody Psychology, Inc.
• Tori Durham, WHNP-BP
• Sarah Durrance, LPC
• Ingrid Duva, RN
• Chad Ryan Dybdahl, A.T.C.
• Eastside Dental Group

• Dentist in Norcross, GA
• Providers in Norcross, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.