Provider Demographics
NPI:1609283977
Name:NGUYEN, HUAN DUY (DDS)
Entity Type:Individual
Prefix:
First Name:HUAN
Middle Name:DUY
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10111 N. EL MIRAGE RD.
Mailing Address - Street 2:SUITE 4
Mailing Address - City:EL MIRAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85335-4643
Mailing Address - Country:US
Mailing Address - Phone:623-551-5444
Mailing Address - Fax:
Practice Address - Street 1:10111 N. EL MIRAGE RD.
Practice Address - Street 2:SUITE 4
Practice Address - City:EL MIRAGE
Practice Address - State:AZ
Practice Address - Zip Code:85335-4643
Practice Address - Country:US
Practice Address - Phone:623-551-5444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0090091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice