Provider Demographics
NPI:1639397300
Name:NGUYEN, TRINH K (DDS)
Entity Type:Individual
Prefix:DR
First Name:TRINH
Middle Name:K
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 1:5150 BUFORD HWY NE
Mailing Address - Street 2:SUITE #B170
Mailing Address - City:DORAVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30340-1153
Mailing Address - Country:US
Mailing Address - Phone:770-452-0630
Mailing Address - Fax:
Practice Address - Street 1:5150 BUFORD HWY NE
Practice Address - Street 2:SUITE #B170
Practice Address - City:DORAVILLE
Practice Address - State:GA
Practice Address - Zip Code:30340-1153
Practice Address - Country:US
Practice Address - Phone:770-452-0630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN011443122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist