Provider Demographics
NPI:1578764882
Name:NGUYEN, JENNIFER BICHLOAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:BICHLOAN
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 1:1325 4TH AVE
Mailing Address - Street 2:SUITE 1230
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2573
Mailing Address - Country:US
Mailing Address - Phone:206-624-1773
Mailing Address - Fax:206-624-2268
Practice Address - Street 1:1325 4TH AVE
Practice Address - Street 2:SUITE 1230
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2573
Practice Address - Country:US
Practice Address - Phone:206-624-1773
Practice Address - Fax:206-624-2268
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2013-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND123911223G0001X
WADE60226224122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice