Provider Demographics
NPI:1043432172
Name:HUYNH, THI (DDS)
Entity Type:Individual
Prefix:DR
First Name:THI
Middle Name:
Last Name:HUYNH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:PETER
Other - Middle Name:
Other - Last Name:HUYNH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1502 NOBLE WAY
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-8116
Mailing Address - Country:US
Mailing Address - Phone:972-359-6087
Mailing Address - Fax:
Practice Address - Street 1:1001 LONG PRAIRIE RD
Practice Address - Street 2:STE.100
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-4202
Practice Address - Country:US
Practice Address - Phone:972-899-7990
Practice Address - Fax:972-899-7993
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX169701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG60207-01OtherCHIP-ARLINGTON
TXG60207-03OtherCHIP-DENTON