Provider Demographics
NPI:1518034818
Name:NGUYEN, HIEN THANH (DDS)
Entity Type:Individual
Prefix:
First Name:HIEN
Middle Name:THANH
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 1:7608 W MILITARY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78227-1928
Mailing Address - Country:US
Mailing Address - Phone:210-645-0000
Mailing Address - Fax:210-673-3616
Practice Address - Street 1:7608 W MILITARY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-1928
Practice Address - Country:US
Practice Address - Phone:210-645-0000
Practice Address - Fax:210-673-3616
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX193701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA978970OtherUNITED CONCORDIA