Provider Demographics
NPI:1942418165
Name:CHI K. NGUYEN, DMD, PA
Entity Type:Organization
Organization Name:CHI K. NGUYEN, DMD, PA
Other - Org Name:CONFIDENT SMILE DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHI
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:NGUEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:727-545-9590
Mailing Address - Street 1:5265 PARK BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3451
Mailing Address - Country:US
Mailing Address - Phone:727-545-9590
Mailing Address - Fax:727-548-8590
Practice Address - Street 1:5265 PARK BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3451
Practice Address - Country:US
Practice Address - Phone:727-545-9590
Practice Address - Fax:727-548-8590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 157191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEMPLOYER ID NUMBER