Provider Demographics
NPI:1497897698
Name:NGUYEN, AN THUY (DDS)
Entity Type:Individual
Prefix:MS
First Name:AN
Middle Name:THUY
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 CLAIREMONT MESA BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1502
Mailing Address - Country:US
Mailing Address - Phone:858-268-3036
Mailing Address - Fax:858-268-3066
Practice Address - Street 1:7450 CLAIREMONT MESA BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1502
Practice Address - Country:US
Practice Address - Phone:858-268-3036
Practice Address - Fax:858-268-3066
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA436451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice