Provider Demographics
NPI:1316294440
Name:NGUYEN, PETER CONG (DMD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:CONG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6356 S PEEK RD STE 700
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-7192
Mailing Address - Country:US
Mailing Address - Phone:714-622-9620
Mailing Address - Fax:346-307-7359
Practice Address - Street 1:6356 S PEEK RD STE 700
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-7192
Practice Address - Country:US
Practice Address - Phone:714-622-9620
Practice Address - Fax:346-307-7359
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056044122300000X
TX304451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist