Provider Demographics
NPI:1235701814
Name:TONGCO NGUYEN, DONNA DENISE (OMD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:DENISE
Last Name:TONGCO NGUYEN
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:DONNA DENISE
Other - Middle Name:ARBOLEDA
Other - Last Name:TONGCO NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OMD
Mailing Address - Street 1:8427 GRANITE SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-7167
Mailing Address - Country:US
Mailing Address - Phone:702-917-2626
Mailing Address - Fax:
Practice Address - Street 1:1481 W WARM SPRINGS RD STE 129
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-7636
Practice Address - Country:US
Practice Address - Phone:702-475-0870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2037171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist