Provider Demographics
NPI:1639399868
Name:NGUYEN, TOAN D (DDS)
Entity Type:Individual
Prefix:
First Name:TOAN
Middle Name:D
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 1:19735 GERMANTOWN RD STE 170
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1216
Mailing Address - Country:US
Mailing Address - Phone:301-528-6633
Mailing Address - Fax:301-540-2595
Practice Address - Street 1:19735 GERMANTOWN RD STE 170
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-1216
Practice Address - Country:US
Practice Address - Phone:301-528-6633
Practice Address - Fax:301-540-2595
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD135171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice