Provider Demographics
NPI:1558454199
Name:NGUYEN, NOLEEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:NOLEEN
Middle Name:
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 1:2621 S BRISTOL ST
Mailing Address - Street 2:#200
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-5766
Mailing Address - Country:US
Mailing Address - Phone:714-549-3180
Mailing Address - Fax:714-549-9642
Practice Address - Street 1:2621 S BRISTOL ST
Practice Address - Street 2:#200
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-5766
Practice Address - Country:US
Practice Address - Phone:714-549-3180
Practice Address - Fax:714-549-9642
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA511171223G0001X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice