Provider Demographics
NPI:1083056543
Name:NGUYEN, TAM T (DMD)
Entity Type:Individual
Prefix:DR
First Name:TAM
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8620 GRAND MISSION BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-5419
Mailing Address - Country:US
Mailing Address - Phone:281-789-8836
Mailing Address - Fax:
Practice Address - Street 1:8620 GRAND MISSION BLVD STE E
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-5419
Practice Address - Country:US
Practice Address - Phone:281-789-8836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX308141223P0221X, 1223G0001X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice