Provider Demographics
NPI:1669447520
Name:NGUYEN, COLLEEN ASHLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:ASHLEY
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9501 STATE AVE
Mailing Address - Street 2:STE 7
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66111-1871
Mailing Address - Country:US
Mailing Address - Phone:913-788-0800
Mailing Address - Fax:913-788-4390
Practice Address - Street 1:9501 STATE AVE
Practice Address - Street 2:STE 7
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66111
Practice Address - Country:US
Practice Address - Phone:913-788-0800
Practice Address - Fax:913-788-4390
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS71411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice