Provider Demographics
NPI:1306094313
Name:NONG, NHUNG (DMD)
Entity type:Individual
Prefix:
First Name:NHUNG
Middle Name:
Last Name:NONG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5535 CYPRESS GARDENS BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-2211
Mailing Address - Country:US
Mailing Address - Phone:863-326-1600
Mailing Address - Fax:
Practice Address - Street 1:5535 CYPRESS GARDENS BLVD STE 120
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-2211
Practice Address - Country:US
Practice Address - Phone:863-326-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN183751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice