Oswego East Dental Associates

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019025958 Issued in IL

Legal business name

OSWEGO EAST DENTAL ASSOCIATES

Practice address

1768 Douglas Rd
Oswego, IL 60543

Phone

(630) 554-5858

NPI assigned

Aug 2, 2010

Last updated

Aug 2, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Phuoc Thanh Vuong, DMD, MS

Title

Dentist

Phone

(630) 862-5169

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280707200000",
    "number": "1275847204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1768 DOUGLAS ROAD",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "60543",
            "telephone_number": "630-554-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1768 DOUGLAS RD",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "60543",
            "telephone_number": "630-554-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSWEGO EAST DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-02",
        "last_updated": "2010-08-02",
        "status": "A",
        "authorized_official_last_name": "VUONG",
        "authorized_official_first_name": "PHUOC",
        "authorized_official_middle_name": "THANH",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "630-862-5169",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Oswego, IL
• Providers in Oswego, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; 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.