Provider Demographics
NPI:1891354072
Name:ALLIED FAMILY DENTISTRY P.C
Entity Type:Organization
Organization Name:ALLIED FAMILY DENTISTRY P.C
Other - Org Name:ALLIED FAMILY DENTISTRRY P.C
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUONG
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-240-1177
Mailing Address - Street 1:12921 W BELLFORT AVE
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-1838
Mailing Address - Country:US
Mailing Address - Phone:281-240-1177
Mailing Address - Fax:
Practice Address - Street 1:12921 WEST BELLFORT AVE
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-1838
Practice Address - Country:US
Practice Address - Phone:281-240-1177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-11
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1396365920Medicaid
TX1831258508Medicaid
TX1861554198Medicaid
TX1891354072Medicaid