Provider Demographics
NPI:1558448811
Name:NGUYEN, NANCY KIM (DDS)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:KIM
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 1:1905 CALLE BARCELONA STE 206B
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-8450
Mailing Address - Country:US
Mailing Address - Phone:760-944-7911
Mailing Address - Fax:760-944-7977
Practice Address - Street 1:1905 CALLE BARCELONA STE 206B
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-8451
Practice Address - Country:US
Practice Address - Phone:760-944-7911
Practice Address - Fax:760-944-7977
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49614122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist