Provider Demographics
NPI:1750475786
Name:NGUYEN, SIMON HOA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SIMON
Middle Name:HOA
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 1:1251 NILLES RD
Mailing Address - Street 2:SUITE #6
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-7206
Mailing Address - Country:US
Mailing Address - Phone:513-939-0848
Mailing Address - Fax:513-939-0811
Practice Address - Street 1:1251 NILLES RD
Practice Address - Street 2:SUITE #6
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-7206
Practice Address - Country:US
Practice Address - Phone:513-939-0848
Practice Address - Fax:513-939-0811
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0211421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice