Individual provider Active NPI

Son T Duong, D.D.S.

  • Dentist
  • Fredericksburg, VA
National Provider Identifier
1386965473
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401412838 Issued in VA
Practice address
1965 Jefferson Davis Hwy
Suite 100
Fredericksburg, VA 22401
Phone
(540) 735-0560
Fax
(540) 735-0567
NPI assigned
Jun 13, 2010
Last updated
Sep 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401412838 VA Primary

Addresses

Primary practice location

1965 Jefferson Davis Hwy
Suite 100
Fredericksburg, VA 22401

Mailing address

1965 Jefferson Davis Hwy
Suite 100
Fredericksburg, VA 22401
Phone (540) 735-0560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160226002103 VA Order and Referring Only - DentistPractitioner - Dentist 4688979750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401412838VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Virginia Health Services Inc Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1276387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1386965473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 JEFFERSON DAVIS HWY",
            "address_2": "SUITE 100",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22401",
            "telephone_number": "540-735-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 JEFFERSON DAVIS HWY",
            "address_2": "SUITE 100",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22401",
            "telephone_number": "540-735-0560",
            "fax_number": "540-735-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUONG",
        "first_name": "SON",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-13",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.