Provider Demographics
NPI:1447571997
Name:RAYMOND, VI NGUYEN (DDS)
Entity Type:Individual
Prefix:
First Name:VI
Middle Name:NGUYEN
Last Name:RAYMOND
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 1:526 S TONOPAH DR
Mailing Address - Street 2:STE. 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4043
Mailing Address - Country:US
Mailing Address - Phone:702-291-2031
Mailing Address - Fax:702-366-1483
Practice Address - Street 1:860 S RANCHO DR
Practice Address - Street 2:STE. 3
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3825
Practice Address - Country:US
Practice Address - Phone:702-878-0808
Practice Address - Fax:702-870-2034
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV61761223G0001X
CA606061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1447571997Medicaid