Provider Demographics
NPI:1386863090
Name:LUU & NGUYEN DENTAL CORPORATION
Entity Type:Organization
Organization Name:LUU & NGUYEN DENTAL CORPORATION
Other - Org Name:PERFECTA DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HIEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-498-3888
Mailing Address - Street 1:314 PALOMAR ST
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-3111
Mailing Address - Country:US
Mailing Address - Phone:619-498-3888
Mailing Address - Fax:619-498-4848
Practice Address - Street 1:314 PALOMAR ST
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-3111
Practice Address - Country:US
Practice Address - Phone:619-498-3888
Practice Address - Fax:619-498-4848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA506561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB50656-01OtherHEALTHY FAMILY
CAG93315-01OtherDENTI-CAL
CA1667740OtherUNITED CONCORDIA TRICARE