Provider Demographics
NPI:1629504998
Name:NGUYEN, THINH XUAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:THINH
Middle Name:XUAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7540 FRESH SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76120-2492
Mailing Address - Country:US
Mailing Address - Phone:682-225-9462
Mailing Address - Fax:
Practice Address - Street 1:5051 S SONCY RD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6667
Practice Address - Country:US
Practice Address - Phone:806-353-1055
Practice Address - Fax:806-353-7077
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX380781223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery