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General NPI Number Information
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NPI Number | 1295710531
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Entity Type | Individual
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Provider Name | QUYNH LAN NGUYEN DMD
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Gender | Female
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Dates
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Enumeration Date | 12/09/2005
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Last Update Date | 05/28/2021
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Provider Practice Location Address
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Address Line | 5705 FONDREN RD STE 104
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City | HOUSTON
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State | TX
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Zip | 77036-1843
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Country | US
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Telephone | 714-781-7827
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Fax | 713-781-7829
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Provider Business Mailing Address
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Address Line | 5115 HAWTHORNE SPRINGS LN
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City | SUGAR LAND
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State | TX
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Zip | 77479-4671
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Country | US
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Telephone | 281-853-4963
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Fax | 713-781-7829
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 26347
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 58171
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE00011142
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 26347
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License Number State | TX
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