MEDICARE: DR. ANH THIEU 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	060906	NY

General Provider Information

NPI Number	:	1831682541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANH THIEU NGUYEN DMD

Provider Business Mailing Address
First Line	:	125 WALKER ST FL 2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10013-4135
Country	:	US
Telephone Number	:	212-226-8866
Fax Number	:	212-226-2289

Provider Business Practice Location Address
First Line	:	131-72 40TH ROAD
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354
Country	:	US
Telephone Number	:	718-587-1111
Fax Number	:	718-886-3903

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

Provider Enumeration Date	:	06/08/2018
Last Update Date	:	04/15/2026

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