Basic Information
| Provider Information | |||||||||
| NPI: | 1689220295 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NGUYEN | ||||||||
| FirstName: | JULIAN | ||||||||
| MiddleName: | NGHIA | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13309 NE 92ND WAY | ||||||||
| Address2: | |||||||||
| City: | REDMOND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980526439 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4255778487 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8820 36TH AVE NE STE 103 | ||||||||
| Address2: | |||||||||
| City: | MARYSVILLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982707268 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607183098 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2019 | ||||||||
| LastUpdateDate: | 08/11/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 60971406 | WA | Y | Dental Providers | Dentist | General Practice |
No ID Information.