Provider Demographics
NPI:1659621183
Name:JENNIFER NGUYEN DDS PLLC
Entity Type:Organization
Organization Name:JENNIFER NGUYEN DDS PLLC
Other - Org Name:SEATTLE SMILES DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:BICHLOAN
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-624-1773
Mailing Address - Street 1:1325 4TH AVE
Mailing Address - Street 2:SUITE 1230
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2573
Mailing Address - Country:US
Mailing Address - Phone:206-624-1773
Mailing Address - Fax:206-624-2268
Practice Address - Street 1:1325 4TH AVE
Practice Address - Street 2:SUITE 1230
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2573
Practice Address - Country:US
Practice Address - Phone:206-624-1773
Practice Address - Fax:206-624-2268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2013-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60226224261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental