Provider Demographics
NPI:1730606781
Name:DUONG, RAYMOND (DMD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:DUONG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 79TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3710
Mailing Address - Country:US
Mailing Address - Phone:917-337-0401
Mailing Address - Fax:
Practice Address - Street 1:16 PARK AVE
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-2442
Practice Address - Country:US
Practice Address - Phone:516-472-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1073531223P0221X
NJ22DI029998001223P0221X
NY0605591223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry