MEDICARE: HONGHA NGUYEN DMD

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	1223G0001X	General Practice Dentistry	D010363	AZ
2	122300000X	Dentist	7333	NV

General Provider Information

NPI Number	:	1184282253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HONGHA NGUYEN DMD

Provider Business Mailing Address
First Line	:	8610 NICHOLS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5377
Country	:	US
Telephone Number	:	951-719-5666
Fax Number	:

Provider Business Practice Location Address
First Line	:	4121 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-3704
Country	:	US
Telephone Number	:	702-257-9090
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2019
Last Update Date	:	11/14/2022

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Directions to “ HONGHA NGUYEN DMD” Practice Location

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