MEDICARE: DR. DUNG Q 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	122300000X	Dentist	048247	NY

General Provider Information

NPI Number	:	1427134709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUNG Q NGUYEN DDS

Provider Business Mailing Address
First Line	:	1806 CATON AVE APT B3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-2726
Country	:	US
Telephone Number	:	718-287-4813
Fax Number	:

Provider Business Practice Location Address
First Line	:	690 FLATBUSH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-6007
Country	:	US
Telephone Number	:	718-693-8200
Fax Number	:

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

Provider Enumeration Date	:	10/28/2006
Last Update Date	:	07/08/2007

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