Provider Demographics
NPI:1831623529
Name:THY NGUYEN DDS LLC
Entity type:Organization
Organization Name:THY NGUYEN DDS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSZEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-363-4300
Mailing Address - Street 1:19873 CENTURY BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-7211
Mailing Address - Country:US
Mailing Address - Phone:301-363-4300
Mailing Address - Fax:301-363-4879
Practice Address - Street 1:19873 CENTURY BLVD STE 210
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-7211
Practice Address - Country:US
Practice Address - Phone:301-363-4300
Practice Address - Fax:301-363-4879
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THY NGUYEN DDS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14258122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty