Provider Demographics
NPI:1053835280
Name:NGUYEN, DUY-LIEM HUU (DMD)
Entity Type:Individual
Prefix:DR
First Name:DUY-LIEM
Middle Name:HUU
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:LIEM
Other - Middle Name:HUU
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:7100 OLD KATY RD APT 2404
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2292
Mailing Address - Country:US
Mailing Address - Phone:832-627-4853
Mailing Address - Fax:
Practice Address - Street 1:7100 OLD KATY RD APT 2404
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2292
Practice Address - Country:US
Practice Address - Phone:832-627-4853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX333881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice