Basic Information
| Provider Information | |||||||||
| NPI: | 1770046864 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NGUYEN | ||||||||
| FirstName: | TUAN | ||||||||
| MiddleName: | ANH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6930 WOODRIDGE ROW DR | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770872758 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6469468337 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1710 W JOE HARVEY BLVD STE B | ||||||||
| Address2: | |||||||||
| City: | HOBBS | ||||||||
| State: | NM | ||||||||
| PostalCode: | 882400821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8889884066 | ||||||||
| FaxNumber: | 8474964850 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2019 | ||||||||
| LastUpdateDate: | 11/12/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 34874 | TX | N | Dental Providers | Dentist | General Practice | 1223G0001X | DD5372 | NM | Y | Dental Providers | Dentist | General Practice |
No ID Information.