Provider Demographics
NPI:1548152341
Name:NGUYEN, SUSAN PHUONG NHI (DDS)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:PHUONG NHI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12014 E COLONIAL DR STE 130
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4751
Mailing Address - Country:US
Mailing Address - Phone:407-205-9585
Mailing Address - Fax:321-236-7686
Practice Address - Street 1:12014 E COLONIAL DR STE 130
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-4751
Practice Address - Country:US
Practice Address - Phone:407-205-9585
Practice Address - Fax:321-236-7686
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN30559122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist