Active NPI
Nga Anh Duong, DMD
- Dentist
- Bonney Lake, WA
National Provider Identifier
1578638672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- BD9843803
- Practice address
- 21105 Sr 410 E
Suite G-4
Bonney Lake, WA 98391-8457 - Phone
- (253) 299-6730
- Fax
- (253) 862-8921
- NPI assigned
- Nov 22, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | BD9843803 | WA | Primary |
| General Practice Dentistry | 1223G0001X | 5175 | NV |
Addresses
Primary practice location
21105 Sr 410 E
Suite G-4
Bonney Lake, WA 98391-8457
Mailing address
21105 Sr 401E
Suite G4
Bonney Lake, WA 98391
Phone (253) 299-6730
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BD9843803 | WA | MD | Dentist |
| 5175 | NV | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452124800000",
"number": "1578638672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21105 SR 401E",
"address_2": "SUITE G4",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "98391",
"telephone_number": "253-299-6730",
"fax_number": "253-862-8921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21105 SR 410 E",
"address_2": "SUITE G-4",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983918457",
"telephone_number": "253-299-6730",
"fax_number": "253-862-8921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUONG",
"first_name": "NGA",
"middle_name": "ANH",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-22",
"last_updated": "2016-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "BD9843803",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NV",
"license": "5175",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonney Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.