Provider Demographics
NPI:1417330523
Name:NGUYEN, PATRICIA (DDS)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19150 NE WOODINVILLE DUVALL RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98077-9477
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19150 NE WOODINVILLE DUVALL RD
Practice Address - Street 2:SUITE 6
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98077-9477
Practice Address - Country:US
Practice Address - Phone:425-788-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE605305881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice