Provider Demographics
NPI:1114045499
Name:NGUYEN-ZIN, JOLENE N (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOLENE
Middle Name:N
Last Name:NGUYEN-ZIN
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 1:10672 WEXFORD ST
Mailing Address - Street 2:SUITE 290
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-3969
Mailing Address - Country:US
Mailing Address - Phone:858-695-8080
Mailing Address - Fax:858-695-8097
Practice Address - Street 1:10672 WEXFORD ST
Practice Address - Street 2:SUITE 290
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-3969
Practice Address - Country:US
Practice Address - Phone:858-695-8080
Practice Address - Fax:858-695-8097
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA400991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice