Provider Demographics
NPI:1154481901
Name:NGUYEN, TAMMY THITHU (DDS)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:THITHU
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8003 NE 151ST CT
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-5602
Mailing Address - Country:US
Mailing Address - Phone:425-398-8766
Mailing Address - Fax:
Practice Address - Street 1:8003 NE 151ST CT
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-5602
Practice Address - Country:US
Practice Address - Phone:425-398-8766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000100251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice