Provider Demographics
NPI:1861521015
Name:NGUYEN, VI MANH (DDS)
Entity type:Individual
Prefix:
First Name:VI
Middle Name:MANH
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 1:2304 MIDWAY RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6124
Mailing Address - Country:US
Mailing Address - Phone:972-473-8880
Mailing Address - Fax:972-473-8882
Practice Address - Street 1:2304 MIDWAY RD
Practice Address - Street 2:SUITE C
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6124
Practice Address - Country:US
Practice Address - Phone:972-473-8880
Practice Address - Fax:972-473-8882
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205941223G0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223G0001XDental ProvidersDentistGeneral Practice
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics