Provider Demographics
NPI:1548790801
Name:NGUYEN, JOSIE (DMD)
Entity Type:Individual
Prefix:
First Name:JOSIE
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5280 N UNIVERSITY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5018
Mailing Address - Country:US
Mailing Address - Phone:954-749-4594
Mailing Address - Fax:
Practice Address - Street 1:5280 N UNIVERSITY DR STE 200
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-5018
Practice Address - Country:US
Practice Address - Phone:954-749-4594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN22692122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist