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NPI Code Detail

MEDICARE: JENNIFER NGUYEN DDS

MEDICARE:   JENNIFER  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
1122300000XDentist31357TX

General Provider Information

NPI Number : 1376919464
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER NGUYEN DDS
Provider Business Mailing Address
First Line : 2011 N HENDERSON AVE
Second Line :
City : DALLAS
State : TX
Zip : 75206-7321
Country : US
Telephone Number : 469-358-8198
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 : 469-358-8198
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2015
Last Update Date : 08/12/2015

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Directions to “ JENNIFER NGUYEN DDS” Practice Location

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