Provider Demographics
NPI:1073934345
Name:BICH-HUONG T. NGUYEN DMD, INC.
Entity Type:Organization
Organization Name:BICH-HUONG T. NGUYEN DMD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BICH-HUONG
Authorized Official - Middle Name:T
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:214-343-9115
Mailing Address - Street 1:12989 JUPITER RD STE 106
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-5248
Mailing Address - Country:US
Mailing Address - Phone:214-343-9115
Mailing Address - Fax:214-343-2779
Practice Address - Street 1:12989 JUPITER RD STE 106
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-5248
Practice Address - Country:US
Practice Address - Phone:214-343-9115
Practice Address - Fax:214-343-2779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13210261QD0000X
TX21448261QD0000X
TX12871261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX090980601Medicaid