Provider Demographics
NPI:1073679635
Name:NGUYEN, CHINH M (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHINH
Middle Name:M
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 1:916 ROBERTS CUT OFF RD STE D
Mailing Address - Street 2:
Mailing Address - City:RIVER OAKS
Mailing Address - State:TX
Mailing Address - Zip Code:76114-2872
Mailing Address - Country:US
Mailing Address - Phone:817-377-4321
Mailing Address - Fax:
Practice Address - Street 1:916 ROBERTS CUT OFF RD STE D
Practice Address - Street 2:
Practice Address - City:RIVER OAKS
Practice Address - State:TX
Practice Address - Zip Code:76114-2872
Practice Address - Country:US
Practice Address - Phone:817-377-4321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX228091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice