Provider Demographics
NPI:1225170764
Name:NGUYEN, CHRISTINE ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ANN
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 1:7705 FLANDERS DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-3453
Mailing Address - Country:US
Mailing Address - Phone:480-254-1133
Mailing Address - Fax:
Practice Address - Street 1:485 S DOBSON RD STE 204
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5604
Practice Address - Country:US
Practice Address - Phone:480-821-9022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7169122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist