Provider Demographics
NPI:1598854580
Name:NGUYEN, CANG H (DDS)
Entity Type:Individual
Prefix:DR
First Name:CANG
Middle Name:H
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 1:3106 SAN GABRIEL BLVD STE G
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-2579
Mailing Address - Country:US
Mailing Address - Phone:626-572-3881
Mailing Address - Fax:626-572-4083
Practice Address - Street 1:3106 SAN GABRIEL BLVD STE G
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-2579
Practice Address - Country:US
Practice Address - Phone:626-572-3881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA551021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice