Michael Duong, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DI22443 Issued in NJ

Practice address

139 Prospect St
Ridgewood, NJ 07450-4405

Phone

(201) 444-7447

Fax

(201) 444-6833

NPI assigned

Mar 11, 2008

Last updated

Dec 25, 2016By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482624000000",
    "number": "1720258361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 PROSPECT ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504405",
            "telephone_number": "201-444-7447",
            "fax_number": "201-444-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 PROSPECT ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504405",
            "telephone_number": "201-444-7447",
            "fax_number": "201-444-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUONG",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-11",
        "last_updated": "2016-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "DI22443",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "050142",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0158267",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Samantha Dunn, LCSW
• Ewa Dziarmaga, MD
• Elizabeth Eapen, M.D.
• Susan Anne Earl, LCSW
• Roseanne Ebert, CD(DONA) LCCE
• Todd Eckert, LCSW

• Orthodontics and Dentofacial Orthopedics Dentistry in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.