Provider Demographics
NPI:1457554933
Name:NGUYEN, LEANN THUY (DDS)
Entity Type:Individual
Prefix:
First Name:LEANN
Middle Name:THUY
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:NGOC-THUY
Other - Middle Name:THI
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6301 NW 78TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-4413
Mailing Address - Country:US
Mailing Address - Phone:816-878-4270
Mailing Address - Fax:
Practice Address - Street 1:3905 S LYNN CT
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-3337
Practice Address - Country:US
Practice Address - Phone:816-254-1622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20070145441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice