Provider Demographics
NPI:1376513861
Name:NGUYEN, VIET QUOC (DDS)
Entity Type:Individual
Prefix:DR
First Name:VIET
Middle Name:QUOC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12630 MONTE VISTA RD STE 109
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2526
Mailing Address - Country:US
Mailing Address - Phone:858-675-2285
Mailing Address - Fax:
Practice Address - Street 1:12630 MONTE VISTA RD STE 109
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2526
Practice Address - Country:US
Practice Address - Phone:858-675-2285
Practice Address - Fax:858-675-9015
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA532551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice