Provider Demographics
NPI:1346485752
Name:NGUYEN, THUY-ANH PHAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:THUY-ANH
Middle Name:PHAM
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 1:4950 BARRANCA PKWY STE 309
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4631
Mailing Address - Country:US
Mailing Address - Phone:949-552-5055
Mailing Address - Fax:949-552-6613
Practice Address - Street 1:4950 BARRANCA PKWY STE 309
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4631
Practice Address - Country:US
Practice Address - Phone:949-552-5055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-14
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA471401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice