Provider Demographics
NPI:1437160108
Name:NGUYEN & TRUONG DENTAL CORP.
Entity Type:Organization
Organization Name:NGUYEN & TRUONG DENTAL CORP.
Other - Org Name:DENTAL 'R' US
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-898-2101
Mailing Address - Street 1:1303 W 6TH ST
Mailing Address - Street 2:STE 103
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-3196
Mailing Address - Country:US
Mailing Address - Phone:951-898-2101
Mailing Address - Fax:
Practice Address - Street 1:1303 W 6TH ST
Practice Address - Street 2:STE 103
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3196
Practice Address - Country:US
Practice Address - Phone:951-898-2101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA465381223G0001X
CA479681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG92313-01Medicaid