Provider Demographics
NPI:1083010573
Name:NGUYEN, HUY CAO (DDS)
Entity Type:Individual
Prefix:DR
First Name:HUY
Middle Name:CAO
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 N HARBOR BLVD STE 154
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-2400
Mailing Address - Country:US
Mailing Address - Phone:714-533-9622
Mailing Address - Fax:714-533-9624
Practice Address - Street 1:1150 N HARBOR BLVD STE 154
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801
Practice Address - Country:US
Practice Address - Phone:714-533-9622
Practice Address - Fax:714-533-9624
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-10
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50084122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist