Provider Demographics
NPI:1992877914
Name:NGUYEN, KIET (DDS)
Entity type:Individual
Prefix:DR
First Name:KIET
Middle Name:
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 1:2131 STATE HIGHWAY 121 STE 200
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-4169
Mailing Address - Country:US
Mailing Address - Phone:817-283-1205
Mailing Address - Fax:817-786-8017
Practice Address - Street 1:2131 STATE HIGHWAY 121 STE 200
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76039-4169
Practice Address - Country:US
Practice Address - Phone:817-283-1205
Practice Address - Fax:817-786-8017
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX181391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice