Provider Demographics
NPI:1316070766
Name:NGUYEN, NGOCTUYEN (DDS)
Entity type:Individual
Prefix:DR
First Name:NGOCTUYEN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 W PRESIDENT GEORGE BUSH HWY
Mailing Address - Street 2:#200
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-1144
Mailing Address - Country:US
Mailing Address - Phone:972-699-7778
Mailing Address - Fax:972-699-7779
Practice Address - Street 1:435 W PRESIDENT GEORGE BUSH HWY
Practice Address - Street 2:#200
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-1144
Practice Address - Country:US
Practice Address - Phone:972-699-7778
Practice Address - Fax:972-699-7779
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX191081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice