Provider Demographics
NPI:1093213316
Name:NGUYEN, PAULA DINH (RDH)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:DINH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:DINH
Other - Last Name:NGUYEN-DANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDH
Mailing Address - Street 1:2220 SE 8TH PL
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-3949
Mailing Address - Country:US
Mailing Address - Phone:206-371-4921
Mailing Address - Fax:
Practice Address - Street 1:2220 SE 8TH PL
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-3949
Practice Address - Country:US
Practice Address - Phone:206-371-4921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH6650124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist