Provider Demographics
NPI:1962885608
Name:NGUYEN, ANDRE HUUNHAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:HUUNHAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ROSE ST RM D-508
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0293
Mailing Address - Country:US
Mailing Address - Phone:859-257-2002
Mailing Address - Fax:859-323-5858
Practice Address - Street 1:800 ROSE ST RM D-508
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-257-2002
Practice Address - Fax:859-323-5858
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012371A122300000X
TX31235122300000X
OH30.24700122300000X
KY10083122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist