Provider Demographics
NPI:1104080167
Name:LUU, NHIEN THUY (DDS)
Entity type:Individual
Prefix:DR
First Name:NHIEN
Middle Name:THUY
Last Name:LUU
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 1:407 N PACIFIC COAST HWY STE 392
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-2872
Mailing Address - Country:US
Mailing Address - Phone:424-257-0717
Mailing Address - Fax:
Practice Address - Street 1:407 N PACIFIC COAST HWY STE 392
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-2872
Practice Address - Country:US
Practice Address - Phone:424-257-0717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA488261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice