Provider Demographics
NPI:1114927076
Name:DANG, MAI THI NHU (DDS)
Entity Type:Individual
Prefix:
First Name:MAI
Middle Name:THI NHU
Last Name:DANG
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 1:14341 BEACH BLVD
Mailing Address - Street 2:STE I
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-4561
Mailing Address - Country:US
Mailing Address - Phone:714-896-0793
Mailing Address - Fax:
Practice Address - Street 1:14341 BEACH BLVD
Practice Address - Street 2:STE I
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4561
Practice Address - Country:US
Practice Address - Phone:714-896-0793
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice