Duy Quoc Nguyen, DDS

Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Jbsa Lackland Afb, TX

NPI 1295025880 · NPPES record last updated Aug 15, 2023

Key facts

NPI
1295025880
Entity type
Individual (NPI type 1)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
License
11407513-9921 (UT)
Practice address
1100 Wilford Hall Loop
Jbsa Lackland Afb, TX 78236
Phone
(210) 292-8626
NPI assigned
Apr 15, 2011
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
39849TXMDOrthodontics and Dentofacial Orthopedic Dentist
11407513-9921UTMDOrthodontics and Dentofacial Orthopedic Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 60648 CA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 39849 TX
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 11407513-9921 UT Yes

Addresses

Primary practice location

1100 Wilford Hall Loop
Jbsa Lackland Afb, TX 78236

Mailing address

1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638
Phone (210) 292-8626

Other providers in Jbsa Lackland Afb, TX

All providers in Jbsa Lackland Afb, TX · Orthodontics and Dentofacial Orthopedics Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.