Provider Demographics
NPI:1790172625
Name:NGUYEN DEHKORDI PLLC
Entity type:Organization
Organization Name:NGUYEN DEHKORDI PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NARGES
Authorized Official - Middle Name:
Authorized Official - Last Name:LOTFIZADEH DEHKORDI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-432-0561
Mailing Address - Street 1:23925 225TH WAY SE STE A
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-5291
Mailing Address - Country:US
Mailing Address - Phone:425-432-0561
Mailing Address - Fax:425-432-2938
Practice Address - Street 1:23925 225TH WAY SE STE A
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-5291
Practice Address - Country:US
Practice Address - Phone:425-432-0561
Practice Address - Fax:425-432-2938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000087731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty