Provider Demographics
NPI:1255825527
Name:NGUYEN, KIMBERLY THUY-HOA (DMD, MSD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:THUY-HOA
Last Name:NGUYEN
Suffix:
Gender:
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 HOUSE WREN LOOP
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3810
Mailing Address - Country:US
Mailing Address - Phone:512-466-9995
Mailing Address - Fax:
Practice Address - Street 1:4105 WESTBANK DR STE 103
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6559
Practice Address - Country:US
Practice Address - Phone:512-327-6908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX337301223P0700X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223P0700XDental ProvidersDentistProsthodontics