Provider Demographics
NPI:1629179809
Name:NGUYEN, DAWN LANHUONG (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:LANHUONG
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 1:650 N CARRIAGE PKWY STE 60
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-4512
Mailing Address - Country:US
Mailing Address - Phone:316-686-2721
Mailing Address - Fax:316-686-2744
Practice Address - Street 1:650 N CARRIAGE PKWY STE 60
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-4512
Practice Address - Country:US
Practice Address - Phone:316-686-2721
Practice Address - Fax:316-686-2744
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53256122300000X
KS607251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200738000AMedicaid
KS1629179809OtherDENTAQUEST