Provider Demographics
NPI:1730675836
Name:NGUYEN, HONGAN MIMI (DMD)
Entity type:Individual
Prefix:DR
First Name:HONGAN
Middle Name:MIMI
Last Name:NGUYEN
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 1:1925 PROSPECT AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6384
Mailing Address - Country:US
Mailing Address - Phone:407-707-6464
Mailing Address - Fax:407-853-6464
Practice Address - Street 1:1925 PROSPECT AVE STE 140
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6384
Practice Address - Country:US
Practice Address - Phone:407-707-6464
Practice Address - Fax:407-853-6464
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-02
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN235311223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry