Provider Demographics
NPI:1760056931
Name:DANG, RICHARD XUANPHONG (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:XUANPHONG
Last Name:DANG
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 WASHBURN AVE
Mailing Address - Street 2:ST 3
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-4362
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:914 WASHBURN AVE
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-4362
Practice Address - Country:US
Practice Address - Phone:714-495-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1113831223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery