Provider Demographics
NPI:1922003557
Name:NGUYEN FAMILY DENTAL, PA
Entity Type:Organization
Organization Name:NGUYEN FAMILY DENTAL, PA
Other - Org Name:SUNNY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KHANH
Authorized Official - Middle Name:DUY
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-481-2048
Mailing Address - Street 1:12804 GULF FWY
Mailing Address - Street 2:STE 400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-4813
Mailing Address - Country:US
Mailing Address - Phone:281-481-2048
Mailing Address - Fax:281-484-4193
Practice Address - Street 1:12804 GULF FWY
Practice Address - Street 2:STE 400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-4813
Practice Address - Country:US
Practice Address - Phone:281-481-2048
Practice Address - Fax:281-484-4193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19859122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty