Healthcare Provider Details

I. General information

NPI: 1861521015
Provider Name (Legal Business Name): VI MANH NGUYEN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2304 MIDWAY RD SUITE C
PLANO TX
75093-6124
US

IV. Provider business mailing address

2304 MIDWAY RD SUITE C
PLANO TX
75093-6124
US

V. Phone/Fax

Practice location:
  • Phone: 972-473-8880
  • Fax: 972-473-8882
Mailing address:
  • Phone: 972-473-8880
  • Fax: 972-473-8882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number20594
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number20594
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: