Provider Demographics
NPI:1497938757
Name:QUYNH NGUYEN DDS, INC.
Entity Type:Organization
Organization Name:QUYNH NGUYEN DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:QUYNH
Authorized Official - Middle Name:C
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-828-6739
Mailing Address - Street 1:7137 DUBLIN BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-3020
Mailing Address - Country:US
Mailing Address - Phone:925-828-6739
Mailing Address - Fax:925-828-7492
Practice Address - Street 1:7137 DUBLIN BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-3020
Practice Address - Country:US
Practice Address - Phone:925-828-6739
Practice Address - Fax:925-828-7492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA479761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty