Provider Demographics
NPI:1740479252
Name:NGUYEN, HOANG THAI (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:HOANG
Middle Name:THAI
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1344 S CHAMBERS RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-4096
Mailing Address - Country:US
Mailing Address - Phone:303-337-2999
Mailing Address - Fax:
Practice Address - Street 1:1344 S CHAMBERS RD
Practice Address - Street 2:SUITE 104
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-4096
Practice Address - Country:US
Practice Address - Phone:303-337-2999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-20
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO90211223G0001X, 1223P0300X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice
No1223P0300XDental ProvidersDentistPeriodontics