Provider Demographics
NPI:1578750105
Name:KATE T. NGUYEN, DDS, MS, PROF. CORP.
Entity Type:Organization
Organization Name:KATE T. NGUYEN, DDS, MS, PROF. CORP.
Other - Org Name:DESERT ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THAO
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-882-5614
Mailing Address - Street 1:6175 SUNDOWN CREST ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-6602
Mailing Address - Country:US
Mailing Address - Phone:702-882-5614
Mailing Address - Fax:
Practice Address - Street 1:6175 SUNDOWN CREST ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-6602
Practice Address - Country:US
Practice Address - Phone:702-882-5614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV47811223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty