Provider Demographics
NPI:1770046864
Name:NGUYEN, TUAN ANH (DDS)
Entity Type:Individual
Prefix:DR
First Name:TUAN
Middle Name:ANH
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 1:6930 WOODRIDGE ROW DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-2758
Mailing Address - Country:US
Mailing Address - Phone:646-946-8337
Mailing Address - Fax:
Practice Address - Street 1:1710 W JOE HARVEY BLVD STE B
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-0821
Practice Address - Country:US
Practice Address - Phone:888-988-4066
Practice Address - Fax:847-496-4850
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-07
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX348741223G0001X
NMDD53721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice