Healthcare Provider Details

I. General information

NPI: 1669936282
Provider Name (Legal Business Name): DENTISTS OF WESTWOOD PC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6175 GLENWAY AVE STE A
CINCINNATI OH
45211-6337
US

IV. Provider business mailing address

PO BOX 920050
DALLAS TX
75392-0050
US

V. Phone/Fax

Practice location:
  • Phone: 513-318-4775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. BACH X NGUYEN
Title or Position: OWNER/DDS
Credential: DDS
Phone: 513-318-4775