Provider Demographics
NPI:1861002859
Name:NGUYEN, NHAYEN PHAM (DDS)
Entity Type:Individual
Prefix:
First Name:NHAYEN
Middle Name:PHAM
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20172 US HIGHWAY 59 STE B
Mailing Address - Street 2:
Mailing Address - City:NEW CANEY
Mailing Address - State:TX
Mailing Address - Zip Code:77357-5084
Mailing Address - Country:US
Mailing Address - Phone:817-202-8101
Mailing Address - Fax:
Practice Address - Street 1:20172 US HIGHWAY 59 STE B
Practice Address - Street 2:
Practice Address - City:NEW CANEY
Practice Address - State:TX
Practice Address - Zip Code:77357-5084
Practice Address - Country:US
Practice Address - Phone:832-604-3518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36489122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice