Provider Demographics
NPI:1356574511
Name:NGUYEN, HENRY-VU THUY (DDS)
Entity type:Individual
Prefix:DR
First Name:HENRY-VU
Middle Name:THUY
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17904 POINT LOMA ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-5043
Mailing Address - Country:US
Mailing Address - Phone:213-610-9697
Mailing Address - Fax:
Practice Address - Street 1:17904 POINT LOMA ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-5043
Practice Address - Country:US
Practice Address - Phone:213-610-9697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58566122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist