Provider Demographics
NPI:1316317696
Name:DO, TUAN (DMD)
Entity type:Individual
Prefix:
First Name:TUAN
Middle Name:
Last Name:DO
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 1:788 W CENTINO DR
Mailing Address - Street 2:UNIT D104
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-5864
Mailing Address - Country:US
Mailing Address - Phone:832-434-3409
Mailing Address - Fax:
Practice Address - Street 1:302 BRIDGE CREST BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-1540
Practice Address - Country:US
Practice Address - Phone:832-434-3409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-30
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94894171223G0001X
TX331691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice