Provider Demographics
NPI:1629555487
Name:NGUYEN, ANH-THU DO (DMD)
Entity Type:Individual
Prefix:
First Name:ANH-THU
Middle Name:DO
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 1:512 NE 81ST ST STE G
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8134
Mailing Address - Country:US
Mailing Address - Phone:360-735-9422
Mailing Address - Fax:877-323-7971
Practice Address - Street 1:512 NE 81ST ST STE G
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8134
Practice Address - Country:US
Practice Address - Phone:360-735-9422
Practice Address - Fax:877-323-7971
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60881703122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1629555487OtherNPI