Provider Demographics
NPI:1558594903
Name:NGUYEN, RYAN TRAN ANH (DMD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:TRAN ANH
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 1:11921 FOXWOOD LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-0029
Mailing Address - Country:US
Mailing Address - Phone:214-263-8633
Mailing Address - Fax:972-530-0917
Practice Address - Street 1:7602 N JUPITER RD
Practice Address - Street 2:SUITE 113
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-2069
Practice Address - Country:US
Practice Address - Phone:972-530-0893
Practice Address - Fax:972-530-0917
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24966122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist