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General NPI Number Information
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NPI Number | 1942871827
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Entity Type | Individual
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Provider Name | SON NGUYEN DDS
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Gender | Male
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Dates
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Enumeration Date | 07/01/2021
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Last Update Date | 08/05/2022
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Provider Practice Location Address
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Address Line | 14025 E EXPOSITION AVE
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City | AURORA
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State | CO
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Zip | 80012-2522
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Country | US
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Telephone | 303-340-0422
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Fax |
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Provider Business Mailing Address
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Address Line | 3313 N GRIMES ST
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City | HOBBS
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State | NM
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Zip | 88240-1219
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Country | US
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Telephone |
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Fax |
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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 | DD5465
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DEN.00204838
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License Number State | CO
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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 | DEN.00204838
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License Number State | CO
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