Provider Demographics
NPI:1386844132
Name:HOANG MINH NGUYEN, DDS, INC.
Entity Type:Organization
Organization Name:HOANG MINH NGUYEN, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOANG
Authorized Official - Middle Name:MINH
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-276-2877
Mailing Address - Street 1:1918 BUSINESS CENTER DR
Mailing Address - Street 2:STE. 210
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3439
Mailing Address - Country:US
Mailing Address - Phone:909-890-9398
Mailing Address - Fax:951-276-1124
Practice Address - Street 1:7120 INDIANA AVE
Practice Address - Street 2:STE. B
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-4500
Practice Address - Country:US
Practice Address - Phone:951-276-2877
Practice Address - Fax:951-276-1124
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOANG MINH NGUYEN, DDS. INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-20
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA408671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty