Provider Demographics
NPI:1235276619
Name:NGUYEN DENTAL INC
Entity Type:Organization
Organization Name:NGUYEN DENTAL INC
Other - Org Name:NGUYEN DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MINH
Authorized Official - Middle Name:DUY
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:562-634-2500
Mailing Address - Street 1:4943 PARAMOUNT BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-2903
Mailing Address - Country:US
Mailing Address - Phone:562-634-2500
Mailing Address - Fax:
Practice Address - Street 1:4943 PARAMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-2903
Practice Address - Country:US
Practice Address - Phone:562-634-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2019-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53257261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental