Provider Demographics
NPI:1124179320
Name:TERRI NGUYEN, D.D.S., INC.
Entity Type:Organization
Organization Name:TERRI NGUYEN, D.D.S., INC.
Other - Org Name:WEST PORTAL FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:M
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-661-7779
Mailing Address - Street 1:26 W PORTAL AVE
Mailing Address - Street 2:SUITE #4
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1304
Mailing Address - Country:US
Mailing Address - Phone:415-661-7779
Mailing Address - Fax:415-592-0137
Practice Address - Street 1:26 W PORTAL AVE
Practice Address - Street 2:SUITE #4
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-1304
Practice Address - Country:US
Practice Address - Phone:415-661-7779
Practice Address - Fax:415-592-0137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty