Healthcare Provider Details

I. General information

NPI: 1235009267
Provider Name (Legal Business Name): NIKKI NGUYEN DENHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NIKKI NGUYEN

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2889 JOSEPH DR
HAMILTON OH
45011
US

IV. Provider business mailing address

3040 N 44TH ST STE 1
PHOENIX AZ
85018-7225
US

V. Phone/Fax

Practice location:
  • Phone: 513-740-8103
  • Fax:
Mailing address:
  • Phone: 714-495-0906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.028521
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: