Provider Demographics
NPI:1306198627
Name:NGUYEN, CHRISTINA MINH THU (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:MINH THU
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 1:27696 BAHAMONDE
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-3232
Mailing Address - Country:US
Mailing Address - Phone:949-228-6822
Mailing Address - Fax:
Practice Address - Street 1:13045 EUCLID ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-1333
Practice Address - Country:US
Practice Address - Phone:714-590-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61941122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA61941OtherDENTAL LICENSE