Provider Demographics
NPI:1952031189
Name:NGUYEN, AMY HA (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:HA
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 1:1116 LAKOTA PL
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-1190
Mailing Address - Country:US
Mailing Address - Phone:972-951-8578
Mailing Address - Fax:
Practice Address - Street 1:5105 ELDORADO PKWY STE 150
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-8676
Practice Address - Country:US
Practice Address - Phone:214-387-0745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-11
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX384661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice