Provider Demographics
NPI:1194192831
Name:NGUYEN, TUONG VI THI
Entity Type:Individual
Prefix:
First Name:TUONG VI
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16517 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-7828
Mailing Address - Country:US
Mailing Address - Phone:714-841-6001
Mailing Address - Fax:714-841-6008
Practice Address - Street 1:16517 MAGNOLIA STREET
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683
Practice Address - Country:US
Practice Address - Phone:714-841-6001
Practice Address - Fax:714-841-6008
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV66991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice