Provider Demographics
NPI:1366445348
Name:NGUYEN, LAN-HUONG DA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAN-HUONG
Middle Name:DA
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 1:749 MONTEREY BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-2221
Mailing Address - Country:US
Mailing Address - Phone:415-239-9140
Mailing Address - Fax:415-239-9141
Practice Address - Street 1:749 MONTEREY BLVD
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-2221
Practice Address - Country:US
Practice Address - Phone:415-239-9140
Practice Address - Fax:415-239-9141
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA416581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA107554OtherACCESS DENTAL
CA44408Medicare UPIN
CA12407Medicare UPIN
CA107554OtherACCESS DENTAL
CA110376-1Medicare UPIN
CAG92690-01Medicare UPIN
CAB41658-01Medicare UPIN