Provider Demographics
NPI:1831321751
Name:NGUYEN, HUNG VU
Entity Type:Individual
Prefix:MR
First Name:HUNG
Middle Name:VU
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:KIEN
Other - Middle Name:HUNGVU
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:261 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-3305
Mailing Address - Country:US
Mailing Address - Phone:212-925-7713
Mailing Address - Fax:
Practice Address - Street 1:261 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3305
Practice Address - Country:US
Practice Address - Phone:212-925-7713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS61156122300000X
NY047933122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist