Provider Demographics
NPI:1417148107
Name:NGUYEN, SCOTTIE H (DDS)
Entity Type:Individual
Prefix:
First Name:SCOTTIE
Middle Name:H
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 1:5588 STATE HIGHWAY 121 STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-6783
Mailing Address - Country:US
Mailing Address - Phone:214-618-0813
Mailing Address - Fax:
Practice Address - Street 1:5588 STATE HIGHWAY 121 STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-6783
Practice Address - Country:US
Practice Address - Phone:214-618-0813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX214531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice