Provider Demographics
NPI:1215026729
Name:NGUYEN, LINH DUY (DDS)
Entity Type:Individual
Prefix:
First Name:LINH
Middle Name:DUY
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 E CASINO RD
Mailing Address - Street 2:STE 4
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-2609
Mailing Address - Country:US
Mailing Address - Phone:206-310-7640
Mailing Address - Fax:425-513-1371
Practice Address - Street 1:206 E CASINO RD STE 4
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-2609
Practice Address - Country:US
Practice Address - Phone:425-347-0547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000076981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5024252Medicaid