Provider Demographics
NPI:1487383170
Name:NGUYEN, THIEN-TRIEU HOANG (DMD)
Entity type:Individual
Prefix:DR
First Name:THIEN-TRIEU
Middle Name:HOANG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7005 OAK COVE DR
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-5015
Mailing Address - Country:US
Mailing Address - Phone:228-243-1764
Mailing Address - Fax:
Practice Address - Street 1:10437 LAMEY BRIDGE RD STE E
Practice Address - Street 2:
Practice Address - City:DIBERVILLE
Practice Address - State:MS
Practice Address - Zip Code:39540-2710
Practice Address - Country:US
Practice Address - Phone:228-388-3353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS4283-22122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist