DR. PHUOC THANH VUONG (NPI# 1073787321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073787321 |
| Entity Type | Individual |
| Full Name | DR. PHUOC THANH VUONG |
| Credential | DMD, MS |
| Practice Address |
6226 14th Ave Kenosha WI 53143-4413 |
| Mailing Address |
538 Conservatory Ln Aurora IL 60502-8913 |
| Practice Telephone | 2626560044 |
| Mailing Telephone | 6308625169 |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2014-11-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 6861-15 | WI | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
019.025958 | IL | Dental Providers |
| Street Address |
6226 14TH AVE |
| City | KENOSHA |
| State | WI |
| Zip Code | 53143-4413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770789489 | Kenosha Community Health Center, Inc | Family Medicine | 6226 14th Ave, Kenosha, WI 53143 | 2007-06-21 |
| 1609424837 | Heather Nicole Matejka | Dentist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2019-08-30 |
| 1801454269 | Connie Lee Bevry | Dental Hygienist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2019-05-31 |
| 1841773793 | Donna M Zagame | Dental Hygienist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2018-09-06 |
| 1033649850 | Melissa Lynn Davis | Dentist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2017-06-14 |
| 1043657158 | Tarah Marie Gerner | Dentist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2013-05-30 |
| 1467715474 | Craig A. Peterson | Dentist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2012-06-25 |
| 1457620031 | Mark Rehorst | Dentist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2011-12-28 |
| 1962788596 | Robyn L. Bednarek | Dental Hygienist | 6226 14th Ave, Suite 700, Kenosha, WI 53143-4413 | 2011-10-27 |
| 1235415993 | Delores Chovan | Dental Hygienist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2011-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891262275 | Shanda L Goecks | Registered Nurse | 6916 26th Ave, Kenosha, WI 53143 | 2018-10-24 |
| 1689942989 | Racine Kenosha Community Action Agency | Public Health or Welfare | 2000 63rd Street, Kenosha, WI 53143 | 2011-12-01 |
| 1538497797 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7525 Sheridan Rd, Kenosha, WI 53143 | 2009-11-30 |
| 1497929012 | Ebba M Johnson | Physical Therapist | 524 74th Street, Kenosha, WI 53143 | 2008-04-15 |
| 1558413161 | Junith M Thompson | Obstetrics & Gynecology | 6530 Sheridan Road, Kenosha, WI 53143 | 2007-01-17 |
| 1154471332 | Ljh Ambulance, Inc | Ambulance | 6329 28th Ave, Kenosha, WI 53143 | 2007-01-11 |
| 1578625794 | Michael A Schellpfeffer Md Ob Gyn Sc | Obstetrics & Gynecology | 1400 75th Street, Kenosha, WI 53143 | 2006-12-14 |
| 1457468654 | Yasmine S Sido | Physician Assistant | 7550 22nd Ave, Kenosha, WI 53143 | 2006-08-24 |
| 1356307359 | Nancy Jane Houtchens | Dentist | 7533 22nd Ave, Ste 100, Kenosha, WI 53143 | 2006-04-26 |
| 1871566257 | Terry W Huff Dds Sc | Clinic/Center | 6402 Sheridan Rd, Kenosha, WI 53143 | 2006-02-08 |
| Find all providers in zip 53143 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881210185 | Negah Karimpourtalebi | Dentist | 6430 Green Bay Rd Ste 112, Kenosha, WI 53142-2948 | 2020-06-23 |
| 1093235871 | Kaleigh E Fulmer | Dentist | 2909 Roosevelt Rd, Kenosha, WI 53143-4641 | 2017-06-22 |
| 1326404641 | Smile Doctors Ltd | Dentist | 7003 39th Ave, Kenosha, WI 53142 | 2016-01-04 |
| 1326425679 | Susan Kang | Dentist | 12752 71st St Apt 101, Kenosha, WI 53142-8428 | 2015-05-06 |
| 1083821169 | Terrence K Frantal Dds Sc | Dentist | 7601 Pershing Blvd, Kenosha, WI 53142-4321 | 2007-05-17 |
| 1659591865 | Mark T Mcguire | Dentist | 4039 80th St Ste C, Kenosha, WI 53142-4959 | 2007-04-27 |
| 1467551887 | Michaelangelo D Aust | Dentist | 6803 Sheridan Rd, Kenosha, WI 53143-1321 | 2006-09-22 |
| 1356307359 | Nancy Jane Houtchens | Dentist | 7533 22nd Ave, Ste 100, Kenosha, WI 53143 | 2006-04-26 |
| 1841287893 | Carlton L Donowa | Dentist | 6032 40th Ave, Kenosha, WI 53142-7018 | 2005-10-04 |
| 1609424837 | Heather Nicole Matejka | Dentist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2019-08-30 |
| Find all providers in KENOSHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.