Provider Demographics
NPI:1295861359
Name:THONG H. NGUYEN, DDS INC.
Entity Type:Organization
Organization Name:THONG H. NGUYEN, DDS INC.
Other - Org Name:EASTWIND DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THONG
Authorized Official - Middle Name:HUU
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-877-2378
Mailing Address - Street 1:7708 DUSTY LYNX CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-0145
Mailing Address - Country:US
Mailing Address - Phone:702-877-2378
Mailing Address - Fax:702-363-2378
Practice Address - Street 1:2381 E WINDMILL LN
Practice Address - Street 2:SUITE 11
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2068
Practice Address - Country:US
Practice Address - Phone:702-877-2378
Practice Address - Fax:702-363-2378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-25
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4837T1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty