Provider Demographics
NPI:1497889869
Name:NGUYEN, HUNG HOANG (DMD)
Entity Type:Individual
Prefix:DR
First Name:HUNG
Middle Name:HOANG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30620 PACIFIC HWY S STE 111
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-4888
Mailing Address - Country:US
Mailing Address - Phone:253-946-3895
Mailing Address - Fax:253-946-8596
Practice Address - Street 1:30620 PACIFIC HWY S STE 111
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-4888
Practice Address - Country:US
Practice Address - Phone:253-946-3895
Practice Address - Fax:253-946-8596
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE82221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice