Provider Demographics
NPI:1245968866
Name:NGUYEN, NGUYEN H (DMD)
Entity type:Individual
Prefix:
First Name:NGUYEN
Middle Name:H
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 545
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-0545
Mailing Address - Country:US
Mailing Address - Phone:508-477-0070
Mailing Address - Fax:508-539-0870
Practice Address - Street 1:96 OLD BARNSTABLE RD
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-3286
Practice Address - Country:US
Practice Address - Phone:508-477-0070
Practice Address - Fax:508-539-0870
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18595511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice