Provider Demographics
NPI:1689704843
Name:LINH D. NGUYEN D.D.S., P.S.
Entity Type:Organization
Organization Name:LINH D. NGUYEN D.D.S., P.S.
Other - Org Name:EVERETT DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:THUY
Authorized Official - Middle Name:Q
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-347-0547
Mailing Address - Street 1:206 E CASINO RD STE 4
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-2609
Mailing Address - Country:US
Mailing Address - Phone:425-347-0547
Mailing Address - Fax:425-513-1371
Practice Address - Street 1:206 E CASINO RD STE 4
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-2609
Practice Address - Country:US
Practice Address - Phone:425-347-0547
Practice Address - Fax:425-513-1371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000076981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty