Provider Demographics
NPI:1851302301
Name:NGUYEN, THAO HIEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:THAO
Middle Name:HIEN
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 1:22094 WESTHEIMER PKWY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-8291
Mailing Address - Country:US
Mailing Address - Phone:281-828-8889
Mailing Address - Fax:
Practice Address - Street 1:22094 WESTHEIMER PKWY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-8291
Practice Address - Country:US
Practice Address - Phone:281-828-8889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133326210Medicaid
TX133326211Medicaid