Healthcare Provider Details

I. General information

NPI: 1629998315
Provider Name (Legal Business Name): ALEXANDER NGUYEN DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15276 W BROOKSIDE LN STE 141
SURPRISE AZ
85374-3998
US

IV. Provider business mailing address

15276 W BROOKSIDE LN STE 141
SURPRISE AZ
85374-3998
US

V. Phone/Fax

Practice location:
  • Phone: 623-584-3098
  • Fax: 623-584-1153
Mailing address:
  • Phone: 623-584-3098
  • Fax: 623-584-1153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DONNEILLIA HAUSS
Title or Position: OFFICE MANAGER
Credential:
Phone: 623-584-3098