Provider Demographics
NPI:1639693195
Name:NGUYEN, KHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:KHA
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 1:24272 E PROSPECT AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5353
Mailing Address - Country:US
Mailing Address - Phone:303-228-0224
Mailing Address - Fax:
Practice Address - Street 1:24272 E PROSPECT AVE UNIT B
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-5353
Practice Address - Country:US
Practice Address - Phone:303-228-0224
Practice Address - Fax:303-228-0224
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002032501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice