Provider Demographics
NPI:1689887259
Name:NGUYEN, ANTHONY T (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:T
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 1:8033 265TH ST
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1532
Mailing Address - Country:US
Mailing Address - Phone:718-347-3304
Mailing Address - Fax:
Practice Address - Street 1:158 E 115TH ST
Practice Address - Street 2:SUITE 222
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-2031
Practice Address - Country:US
Practice Address - Phone:212-360-5941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0369051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice