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NPI Code Detail

MEDICARE: DR. CUNG LUONG NGUYEN D.D.S.

MEDICARE: DR. CUNG LUONG 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
11223G0001XGeneral Practice Dentistry23595TX

General Provider Information

NPI Number : 1316120926
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CUNG LUONG NGUYEN D.D.S.
Provider Business Mailing Address
First Line : 2011 N HENDERSON AVE
Second Line :
City : DALLAS
State : TX
Zip : 75206-7321
Country : US
Telephone Number : 214-823-2182
Fax Number :
Provider Business Practice Location Address
First Line : 2011 N HENDERSON AVE
Second Line :
City : DALLAS
State : TX
Zip : 75206-7321
Country : US
Telephone Number : 148-232-2182
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2007
Last Update Date : 10/01/2019

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