Provider Demographics
NPI:1578686267
Name:NGUYEN, CENDRINE (DDS)
Entity Type:Individual
Prefix:
First Name:CENDRINE
Middle Name:
Last Name:NGUYEN
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 1:4510 PARK MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-7592
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5949 BROADWAY BLVD
Practice Address - Street 2:SUITE 115
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-3845
Practice Address - Country:US
Practice Address - Phone:214-703-9500
Practice Address - Fax:214-703-9404
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX211091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice