Provider Demographics
NPI:1730477670
Name:CHU, NGUYENANH (DDS)
Entity Type:Individual
Prefix:
First Name:NGUYENANH
Middle Name:
Last Name:CHU
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 1:6955 OAKLAND MILLS RD STE O
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5849
Mailing Address - Country:US
Mailing Address - Phone:410-290-6974
Mailing Address - Fax:
Practice Address - Street 1:6955 OAKLAND MILLS RD STE O
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5849
Practice Address - Country:US
Practice Address - Phone:410-290-6974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12199122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist