Provider Demographics
NPI:1396927299
Name:NGUYEN, KHANH VU THUY (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:KHANH
Middle Name:VU THUY
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 MORAGA AVE STE A104
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-5469
Mailing Address - Country:US
Mailing Address - Phone:858-273-3181
Mailing Address - Fax:858-299-6000
Practice Address - Street 1:3737 MORAGA AVE STE A104
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117
Practice Address - Country:US
Practice Address - Phone:858-273-3181
Practice Address - Fax:619-299-2000
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA530191223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics