Provider Demographics
NPI:1205186897
Name:NGUYEN, KIM THIEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:THIEN
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 1:8421 PEPPERWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-6330
Mailing Address - Country:US
Mailing Address - Phone:714-661-4812
Mailing Address - Fax:
Practice Address - Street 1:8421 PEPPERWOOD CIR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-6330
Practice Address - Country:US
Practice Address - Phone:714-661-4812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61874122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist