Provider Demographics
NPI:1487004032
Name:ANTHONY NGUYEN DDS INC
Entity Type:Organization
Organization Name:ANTHONY NGUYEN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-307-8797
Mailing Address - Street 1:14501 MAGNOLIA ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-1306
Mailing Address - Country:US
Mailing Address - Phone:714-248-9883
Mailing Address - Fax:714-248-9774
Practice Address - Street 1:14501 MAGNOLIA ST
Practice Address - Street 2:SUITE 107
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-1306
Practice Address - Country:US
Practice Address - Phone:714-248-9883
Practice Address - Fax:714-248-9774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-14
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41290305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization