Provider Demographics
NPI:1346304458
Name:NGUYEN, TRINH P (DDS)
Entity type:Individual
Prefix:
First Name:TRINH
Middle Name:P
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 1:5515 CAMINO AL NORTE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-0819
Mailing Address - Country:US
Mailing Address - Phone:702-633-6332
Mailing Address - Fax:702-644-7822
Practice Address - Street 1:5515 CAMINO AL NORTE
Practice Address - Street 2:SUITE 100
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-0819
Practice Address - Country:US
Practice Address - Phone:702-633-6332
Practice Address - Fax:702-644-7822
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV42721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100505327Medicaid