Provider Demographics
NPI:1871278796
Name:NGUYEN, VICTORIA (DMD)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2497 CLAIRMONT DR W
Mailing Address - Street 2:
Mailing Address - City:SEMMES
Mailing Address - State:AL
Mailing Address - Zip Code:36575-3315
Mailing Address - Country:US
Mailing Address - Phone:228-357-0595
Mailing Address - Fax:
Practice Address - Street 1:1651 SCHILLINGER RD N
Practice Address - Street 2:
Practice Address - City:SEMMES
Practice Address - State:AL
Practice Address - Zip Code:36575-7409
Practice Address - Country:US
Practice Address - Phone:251-706-7960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX398781223G0001X
FL284281223G0001X
ALD.007235-C11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice