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NPI Code Detail

MEDICARE: TANIA DUC NGUYEN DDS

MEDICARE: TANIA DUC NGUYEN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryD6798AZ

General Provider Information

NPI Number : 1518019595
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANIA DUC NGUYEN DDS
Provider Business Mailing Address
First Line : 7600 NORTH 15TH STREET
Second Line : 170
City : PHOENIX
State : AZ
Zip : 85020
Country : US
Telephone Number : 602-870-1223
Fax Number : 602-997-4951
Provider Business Practice Location Address
First Line : 8910 NORTH 43RD AVE
Second Line : 104
City : GLENDALE
State : AZ
Zip : 85302
Country : US
Telephone Number : 623-939-5131
Fax Number : 623-939-5361
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 07/08/2007

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Directions to “ TANIA DUC NGUYEN DDS” Practice Location

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