Provider Demographics
NPI:1861949638
Name:LINH K NGUYEN DDS PLLC
Entity type:Organization
Organization Name:LINH K NGUYEN DDS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINH
Authorized Official - Middle Name:KHANH
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-696-2322
Mailing Address - Street 1:15761 NORTHUP WAY
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-2555
Mailing Address - Country:US
Mailing Address - Phone:206-696-2322
Mailing Address - Fax:
Practice Address - Street 1:1002 HARVEY RD NE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4220
Practice Address - Country:US
Practice Address - Phone:206-696-2322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1710264312OtherINDIVIDUAL NPI