Healthcare Provider Details

I. General information

NPI: 1588585681
Provider Name (Legal Business Name): TUONGVI NGUYEN DAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10664 E POINT TWENTY TWO BLVD
MESA AZ
85212-8874
US

IV. Provider business mailing address

10664 E POINT TWENTY TWO BLVD
MESA AZ
85212-8874
US

V. Phone/Fax

Practice location:
  • Phone: 480-360-3073
  • Fax: 480-448-3813
Mailing address:
  • Phone: 480-360-3073
  • Fax: 480-448-3813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberH012911
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: