Provider Demographics
NPI:1497932891
Name:NGUYEN, CHRISTOPHER KHIEM (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:KHIEM
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15972 EUCLID ST
Mailing Address - Street 2:STE. F
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-1133
Mailing Address - Country:US
Mailing Address - Phone:714-839-7660
Mailing Address - Fax:714-839-7693
Practice Address - Street 1:15972 EUCLID ST
Practice Address - Street 2:STE. F
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-1133
Practice Address - Country:US
Practice Address - Phone:714-839-7660
Practice Address - Fax:714-839-7693
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39851122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist