Dzung Duc-Tien Mang, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

ME86632 Issued in FL

Practice address

6650 78TH Avenue N
Pinellas Park, FL 33781-2053

Phone

(727) 548-7600

Fax

(727) 548-7608

NPI assigned

Dec 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Brandon-Dzung Duc-Tien Mang Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1629132899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6650 78TH AVENUE N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337812053",
            "telephone_number": "727-548-7600",
            "fax_number": "727-548-7608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6650 78TH AVENUE N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337812053",
            "telephone_number": "727-548-7600",
            "fax_number": "727-548-7608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANG",
        "first_name": "DZUNG",
        "middle_name": "DUC-TIEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME86632",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "054429",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDON-DZUNG",
            "last_name": "MANG",
            "middle_name": "DUC-TIEN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Majestic Bayside LLC
• Tatiana Y Makarova, PHARM D
• Briana Natalie Maldonado
• Nicole Annlee Piper Maloney, LMHC
• Dat Dultien Mang, DMD
• Gagandeep Singh Mangat, M.D.
• Amber Lynne Mangum, RBT
• Jennifer L Manning, O.D.
• Scott Rasheed Manningham, MS
• Anja O Mansco, LMT, NCBTMB

• Plastic Surgery Physician in Pinellas Park, FL
• Providers in Pinellas Park, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.