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NPI Code Detail

MEDICARE: ANH QUYNH NGUYEN D.D.S

MEDICARE: ANH QUYNH NGUYEN D.D.S
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
1122300000XDentist28647TX

General Provider Information

NPI Number : 1134469877
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANH QUYNH NGUYEN D.D.S
Provider Business Mailing Address
First Line : 3425 GRANDE BULEVAR
Second Line :
City : IRVING
State : TX
Zip : 75062-5108
Country : US
Telephone Number : 972-639-5836
Fax Number : 469-586-4761
Provider Business Practice Location Address
First Line : 3425 GRANDE BULEVAR
Second Line :
City : IRVING
State : TX
Zip : 75062-5108
Country : US
Telephone Number : 972-639-5836
Fax Number : 469-586-4761
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2013
Last Update Date : 10/23/2019

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