Provider Demographics
NPI:1629451166
Name:NGUYEN, TUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:TUNG
Middle Name:
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 1:1605 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-4302
Mailing Address - Country:US
Mailing Address - Phone:206-434-5882
Mailing Address - Fax:
Practice Address - Street 1:15446 BEL RED RD STE 300
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5507
Practice Address - Country:US
Practice Address - Phone:425-883-3399
Practice Address - Fax:425-883-3391
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE605801261223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry