Provider Demographics
NPI:1598951519
Name:NGUYEN, ANHPHI THI (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANHPHI
Middle Name:THI
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 1:653 COLUMBIA RD FL 1
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-1712
Mailing Address - Country:US
Mailing Address - Phone:617-825-9100
Mailing Address - Fax:617-825-5006
Practice Address - Street 1:653 COLUMBIA RD
Practice Address - Street 2:FL. 1
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02125-1712
Practice Address - Country:US
Practice Address - Phone:617-825-9100
Practice Address - Fax:617-825-5006
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice