Provider Demographics
NPI:1235219049
Name:SON AND LIEN NGUYEN, PS
Entity Type:Organization
Organization Name:SON AND LIEN NGUYEN, PS
Other - Org Name:BURIEN PLAZA DENTAL AND DENTURES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SON
Authorized Official - Middle Name:C
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-246-7999
Mailing Address - Street 1:116 SW 148TH ST
Mailing Address - Street 2:SUITE D100
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-1983
Mailing Address - Country:US
Mailing Address - Phone:206-246-7999
Mailing Address - Fax:206-246-7788
Practice Address - Street 1:116 SW 148TH ST
Practice Address - Street 2:SUITE D100
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-1983
Practice Address - Country:US
Practice Address - Phone:206-246-7999
Practice Address - Fax:206-246-7788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA94201223G0001X
WA94021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5043534Medicaid