Provider Demographics
NPI:1689220295
Name:NGUYEN, JULIAN NGHIA (DDS)
Entity Type:Individual
Prefix:
First Name:JULIAN
Middle Name:NGHIA
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 1:13309 NE 92ND WAY
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-6439
Mailing Address - Country:US
Mailing Address - Phone:425-577-8487
Mailing Address - Fax:
Practice Address - Street 1:8820 36TH AVE NE STE 103
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-7268
Practice Address - Country:US
Practice Address - Phone:360-718-3098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-11
Last Update Date:2019-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA609714061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice