MEDICARE: THANG QUOC NGUYEN DDS

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	DN011799	GA

General Provider Information

NPI Number	:	1295919322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THANG QUOC NGUYEN DDS

Provider Business Mailing Address
First Line	:	3273 SHALLOWFORD RD NE
Second Line	:
City	:	CHAMBLEE
State	:	GA
Zip	:	30341-3632
Country	:	US
Telephone Number	:	770-394-6778
Fax Number	:	770-394-5060

Provider Business Practice Location Address
First Line	:	3273 SHALLOWFORD RD NE
Second Line	:
City	:	CHAMBLEE
State	:	GA
Zip	:	30341-3632
Country	:	US
Telephone Number	:	770-394-6778
Fax Number	:	770-394-5060

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

Provider Enumeration Date	:	12/26/2007
Last Update Date	:	10/17/2025

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