Provider Demographics
NPI:1518086990
Name:NGUYEN, DU HUU (DDS)
Entity Type:Individual
Prefix:
First Name:DU
Middle Name:HUU
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 1:1305 W. ARROW HYW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773
Mailing Address - Country:US
Mailing Address - Phone:909-599-8855
Mailing Address - Fax:909-599-5333
Practice Address - Street 1:1305 W ARROW HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-2336
Practice Address - Country:US
Practice Address - Phone:909-599-8855
Practice Address - Fax:909-599-5333
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA491651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice