Derek Dungquang Duong Professional Dental Corp

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48906 Issued in CA

Legal business name

DEREK DUNGQUANG DUONG PROFESSIONAL DENTAL CORP

Practice address

2263 Fairview Rd Ste K
Costa Mesa, CA 92627-1672

Phone

(949) 515-9280

Fax

(949) 515-9289

NPI assigned

Jan 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Derek Dungquang Duong, DMD

Title

President

Phone

(949) 515-9280

Specialties & licenses 1

Addresses

Other names 1

• COASTAL DENTAL GROUP Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandy Phan, DMD

  • General Practice Dentistry
  • Costa Mesa, CA
  • NPI 1295854099
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514505600000",
    "number": "1144370768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2263 FAIRVIEW RD STE K",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926271672",
            "telephone_number": "949-515-9280",
            "fax_number": "949-515-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2263 FAIRVIEW RD STE K",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926271672",
            "telephone_number": "949-515-9280",
            "fax_number": "949-515-9289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK DUNGQUANG DUONG PROFESSIONAL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2017-12-29",
        "status": "A",
        "authorized_official_last_name": "DUONG",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "DUNGQUANG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-515-9280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COASTAL DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly Demartino, CADC-II
• Afrouz Demehri, N.D
• Christy Demetriades, M.S.
• Taylor Jo Denny
• Miguel Gaerlan Deperio, M.D.
• Tor Eran Des Roches, MSW
• Asha Desai, BCBA
• Kiara Desuyo
• Danielle Devinney
• Jessica Cameron Butler Dewilde, LCSW

• General Practice Dentistry in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; 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.