MEDICARE: UN DMD, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1124957295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UN DMD, PLLC

Provider Business Mailing Address
First Line	:	15010 MONTEZUMA QUAIL DR
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-7866
Country	:	US
Telephone Number	:	503-432-0409
Fax Number	:

Provider Business Practice Location Address
First Line	:	7355 FM 359 RD. S.
Second Line	:	SUITE A-2
City	:	FULSHEAR
State	:	TX
Zip	:	77441
Country	:	US
Telephone Number	:	832-429-2289
Fax Number	:	832-429-2287

Authorized Official
Title or Position	:	OWNER/GENERAL DENTIST
Name	:	DR. UAN CONG NGUYEN
Credential	:	DMD
Telephone Number	:	503-432-0409

Provider Enumeration Date	:	05/15/2026
Last Update Date	:	05/15/2026

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